U.S. Department of Justice Office of Justice Programs Bureau of Justice Assistance
Family Dependency Treatment Courts: Addressing Child Abuse and Neglect Cases MONOGRUsing the Drug Court APH Model D ECEMBER 2004
Bureau of Justice Assistance U.S. Department of Justice Office of Justice Programs 810 Seventh Street NW. Washington, DC 20531
John Ashcroft Attorney General
Deborah J. Daniels Assistant Attorney General
Domingo S. Herraiz Director, Bureau of Justice Assistance
Office of Justice Programs Partnerships for Safer Communities www.ojp.usdoj.gov
Bureau of Justice Assistance www.ojp.usdoj.gov/BJA
NCJ 206809
This document was prepared by the National Drug Court Institute and Center for Substance Abuse Treatment, under the Drug Court Training and Technical Assistance Program, under contract number 282–98–0023, funded by the Center for Substance Abuse Treatment.The opinions, findings, and conclusions or recommendations expressed in this document are those of the authors and do not necessarily represent the official position or policies of the U.S. Department of Justice.
The Bureau of Justice Assistance is a component of the Office of Justice Programs, which also includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, and the Office for Victims of Crime. Family Dependency Treatment Courts: Addressing Child Abuse and Neglect Cases Using the Drug Court Model
Center for Substance Abuse Treatment Substance Abuse and Mental Health Services Administration U.S. Department of Health and Human Services
Bureau of Justice Assistance Office of Justice Programs U.S. Department of Justice
Prepared by National Drug Court Institute and Center for Substance Abuse Treatment
Reviewed and Revised by Center for Substance Abuse Treatment, Bureau of Justice Assistance, National Drug Court Institute, National Council of Juvenile and Family Court Judges, and Permanency Planning for Children Division
Disclaimer
The opinions expressed herein reflect the views of a focus group conducted by the above-mentioned organizations and do not reflect the official position of the Bureau of Justice Assistance (BJA), the Office of Justice Programs (OJP), the U.S. Department of Justice (DOJ); the Center for Substance Abuse Treatment (CSAT), the Substance Abuse and Mental Health Services Administration (SAMHSA), the U.S. Department of Health and Human Services (DHHS); or the National Drug Court Institute (NDCI). BJA, OJP, DOJ, CSAT, SAMHSA, DHHS, and NDCI express no official support or endorsement of these opinions or of particular approaches described in this document. Any guidelines on substance abuse treatment presented in this document should not be considered substitutes for individualized patient care and treatment decisions.
December 2004
1 Acknowledgments
This monograph, Family Dependency Treatment Courts: Addressing Child Abuse and Neglect Cases Using the Drug Court Model, was produced under contract number 282–98–0023, funded by the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, 5600 Fishers Lane, Rockwall II, Suite 621, Rockville, Maryland, 20857, telephone 301–443–5052. The contractees were the National Drug Court Institute (NDCI) and ROW Sciences, Inc. Bruce Fry, J.D., served as the CSAT government project officer. Betsy Earp, ROW Sciences, Inc., wrote this monograph, and Kathleen R. Snavely, NDCI, served as managing editor. NDCI and CSAT would also like to acknowledge the hard work of Susan Weinstein and Rita Trapani of the National Association of Drug Court Professionals for their invaluable editorial assistance and massaging of the text. Appreciation is also extended to the field reviewers of this publication:
Andrea Murphy Nancy K. Young, Ph.D. Marilyn McCoy Roberts The Honorable Charles M. McGee Cynthia Lu, J.D. Penny Howell, LMSW Kathleen Phillips, Esq. The Honorable Nicolette Pach
Meghan Wheeler, NDCI, and Nancy Tribble, National Council of Juvenile and Family Court Judges, served as the review and revision team. Susan Yeres served as the team’s writer and editor. Bruce Fry, CSAT, and Jennifer Columbel, formerly of the Bureau of Justice Assistance, served as final reviewers.
2 Contents
Introduction
Chapter 1 Background: History, Definition, Mission, and Goals of the Family Dependency Treatment Court
Chapter 2 How the Family Dependency Treatment Court Fits Into the Justice System
Chapter 3 Common Characteristics of Four Early Family Dependency Treatment Courts
Chapter 4 Varying Approaches
Chapter 5 Community Stakeholders
Chapter 6 Permanency and Safety for Children: Implications of the Adoption and Safe Families Act of 1997
Chapter 7 Recommendations of the Focus Group
Chapter 8 Current Initiatives
Appendix A: Focus Group Participant FDTC Program Descriptions
Appendix B. Adoption and Safe Families Act Timeline
Appendix C: Recommendations for Research and Evaluation
Appendix D: Family Intervention Programs
Appendix E: Strengths, Challenges, Opportunities, and Threats
Appendix F: Focus Group Participants
Appendix G: Other CSAT Resources
Notes
References
3 Introduction
What Is a Family Dependency Treatment Court?
A family dependency treatment court is a court devoted to cases of child abuse and neglect that involve substance abuse by the child’s parents or other caregivers. Its purpose is to protect the safety and welfare of children while giving parents the tools they need to become sober, responsible caregivers. To accomplish this, the court draws together an interdisciplinary team that works collaboratively to assess the family’s situation and to devise a comprehensive case plan that addresses the needs of both the children and the parents. In this way, the court team provides children with quick access to permanency and offers parents a viable chance to achieve sobriety, provide a safe and nurturing home, and hold their families together.
The first family dependency treatment court (FDTC) opened in 1994 in Reno, Nevada, marking the beginning of a movement that has since taken hold in cities and counties across the United States. The ideas presented in this monograph are rooted in a 1999 gathering of teams from some of the most well-established FDTCs: Kansas City, Missouri; Reno, Nevada; San Diego, California; and Suffolk County, New York. This 2-day focus group was convened by the National Association of Drug Court Professionals (NADCP), the National Drug Court Institute (NDCI), and the Center for Substance Abuse Treatment (CSAT). Its purpose was to provide a forum where practitioners from this emerging field could share their experiences in planning and implementing FDTCs.
The focus group explored the pros and cons of various approaches to the development and operation of FDTCs, formulated a mission and overall goals for the court, and took the first steps toward devising a national strategy for advancing the FDTC concept. The group also considered a broader perspective on FDTCs, exploring their place within the American justice system as a whole. It compared the FDTC structure to both the adult drug court model and to the traditional family (dependency) court model, clarifying the FDTC’s roots, special characteristics, and unique role.
Following the 1999 focus group, a number of projects—including training, technical assistance, and evaluation—were initiated to help other jurisdictions develop and implement family dependency treatment courts. Chapter 8 describes the specific resources offered to jurisdictions through these projects.
The Purpose of This Publication
This publication documents the ideas, discussions, and conclusions of the 1999 focus group. We caution, however, that because the FDTC is a model-in-progress, this document is not intended as a blueprint or “how-to” guide for establishing an FDTC. Nor is it meant to comprehensively address each area that is discussed. Instead, it is hoped that by consolidating the early experiences of the first courts, the stage will be set for other communities to make their own contributions to this exciting new collaboration among the judicial, child protection, and treatment fields.
4 Chapter 1 Background: History, Definition, Mission, and Goals of the Family Dependency Treatment Court
Why Family Dependency Treatment Courts?
Since the mid-1980s, a dramatic rise in cases of child abuse and neglect has overwhelmed the nation’s courts and child welfare agencies. Each year, more than 1 million cases of child abuse and neglect are filed and substantiated; as of April 2001, the foster care system was responsible for more than 588,000 children (U.S. Department of Health and Human Services, 2001).
Many factors may account for the escalation in abuse and neglect, including poverty, domestic violence, and an increasing personal mobility that results in the loss of family support systems. However, the primary cause is clear: substance abuse and addiction. According to Linking Child Welfare and Substance Abuse Treatment: A Guide for Legislators (National Conference of State Legislatures, 2000), “a large percentage of parents who abuse, neglect, or abandon their children have drug and alcohol problems. . . . Although national data are incomplete, it is estimated that substance abuse is a factor in three-fourths of all foster care placements.” Also, Kelleher et al. (1994) write that “children whose parents abuse drugs and alcohol are nearly three times more likely to be abused and more than four times likely to be neglected than children of parents who are not substance abusers.”
It is not surprising that substance abuse and addiction are so frequently associated with the neglect and abuse of children. Parents battling substance abuse often put the needs created by their own alcohol or drug dependency ahead of the welfare of their families. At the same time, they—and their children—often have complicating physical or mental health problems. Unable to maintain employment or provide a stable and nurturing home environment, they are unable to care for their children.
The rapid increase of abuse and neglect cases due to parental substance abuse poses an immense challenge for dependency courts, child welfare systems, and treatment providers. Attaining treatment for families—especially treatment that is timely, accessible, and appropriate—has always been difficult. But with the burgeoning number of parents in need of treatment, courts and providers have been strained to capacity. Also, without a coordinated effort among them, these systems are not equipped to handle the specialized issues that permeate cases of abuse and neglect that stem from parental substance abuse. As a result, parents are likely to continue their addiction as their children, unable to return home, languish in foster care.
Recognizing that the complex web of problems affecting these families could be adequately addressed only through a coordinated approach to breaking the cycle of substance abuse and child maltreatment, a number of practitioners in juvenile dependency courts, child protective services, and substance abuse treatment systems began experimenting with a more holistic approach to intervention. In doing this, they looked to an earlier experiment in the coordination of judicial and treatment services—the adult drug court.
5 Adult Drug Courts: An Example To Follow
As far back as the 1950s, drug and alcohol abuse weighed heavily on the nation’s court systems. By the 1980s, the burden was overwhelming. Offenders cycled in and out of court, their substance abuse problems either overlooked or left untreated—at times simply because the court lacked cooperative working relationships with providers. Those who entered treatment were often unmotivated and unmonitored, and they frequently dropped out unnoticed.
Because the adversarial nature of the justice system was failing to break the cycle of substance abuse, some jurisdictions began to reexamine the relationship between criminal justice processing and treatment services. It became apparent that treatment providers and criminal justice practitioners shared two common goals: stopping the use and abuse of addictive substances, and reducing crime. In 1989, Dade County, Florida used that realization to its advantage, opening the nation’s first modern drug court. For more than a decade since then, adult drug courts have helped criminal offenders achieve sobriety and break the cycle of addiction and criminal behavior. These successes can be attributed to a set of key practices that include integrating treatment with justice case processing, a nonadversarial approach, early intervention, access to a continuum of services, frequent drug testing, use of a coordinated strategy to address behavioral change, ongoing judicial interactions, monitoring and evaluation of goals and outcomes, cross-disciplinary training, and partnerships among community organizations and agencies that generate support and enhance programming (National Association of Drug Court Professionals Drug Court Standards Committee, 1997).
The success of the adult drug court provided inspiration for professionals struggling with the onslaught of child abuse and neglect resulting from substance abuse by parents. They drew on the concept of collaboration between the criminal justice and drug treatment fields and combined this with the best aspects of family and juvenile court practices. What emerged were the family dependency treatment courts.
Four Early Family Dependency Treatment Courts
In September 1994, the Second Judicial District Court of Washoe County (Reno), Nevada, convened the first session of an FDTC. When the 1999 focus group met, 10 FDTCs were operating around the country, with approximately 10 more in the planning stages.
Like the adult drug courts that inspired them, the first FDTCs took a collaborative approach to therapeutic jurisprudence, building teams that included judges, treatment providers, child welfare specialists, attorneys (including the prosecution as well as those representing the protection agencies, the parents, and the child), and other key service providers. Together, these practitioners operated a formal program of early intervention and treatment based on a comprehensive needs assessment and case plan. Frequent court appearances held both the parents and the systems accountable for compliance and outcomes.
6 Definition, Mission, and Goals of the FDTC
As defined in Juvenile and Family Drug Courts: An Overview (Drug Court Clearinghouse and Technical Assistance Project at the American University, 1998), an FDTC is “a court that deals with cases involving parental rights, in which an adult is the party litigant, which come before the court through either the criminal or civil process, which arise out of the substance abuse of a parent.”
An alternate definition crafted by the 1999 focus group emphasized the process through which the court responds to these cases:
A family dependency treatment court is a collaborative effort in which court, treatment, and child welfare practitioners come together in a nonadversarial setting to conduct comprehensive child and parent needs assessments. With these assessments as a base, the team builds workable case plans that give parents a viable chance to achieve sobriety, provide a safe nurturing home, become responsible for themselves and their children, and hold their families together.
From its discussions, the focus group also developed the following mission and goals for the FDTC.
Mission
To protect children from abuse and neglect—precipitated by the substance abuse of a parent or caregiver—by addressing the comprehensive issues of both the parents and their children through an integrated, court-based collaboration among service providers who work as a team to achieve timely decisions, coordinated treatment and ancillary services, judicial oversight, and safe and permanent placements.
Goals
• To provide appropriate, timely, and permanent placement of children in a safe healthy environment.
• To stop the cycle of abuse and neglect in families.
• To provide children and parents with the services and skills needed to live productively in the community and to establish a safe, healthy environment for their families.
• To respond to family issues using a strength-based approach.
• To provide a continuum of family-based treatment and ancillary services for children and parents affected by substance use, abuse, and dependence.
• To provide continuing care and information that families need to access the services they may require to function responsibly.
7
• To develop cost-effective programming and interventions using the ongoing allocation of resources to support parents and their children.
• To provide gender-specific, culturally and developmentally appropriate treatment.
• To avoid delays in case processing by ensuring parental compliance with court orders and ancillary services, and by facilitating the court’s ability to modify court orders as cases progress.
• To foster collaborative relationships among the systems operating in the community so they can effectively manage cases involving the abuse and neglect of children.
The next section examines FDTCs in the context of the broader justice system.
8 Chapter 2 How the Family Dependency Treatment Court Fits Into the Justice System
The family dependency treatment court (FDTC) draws on a rich judicial history, blending drug court practices with those of traditional family dependency courts. To clarify its place within the justice system, the focus group identified key factors from adult drug courts, traditional dependency courts, and family dependency treatment courts for comparison. The results of their discussion are shown in table 1.
Table 1. Comparison of Drug Court Models Traditional Family Dependency Adult Drug Court Dependency Court Treatment Court Client Adult or parent who is Children who have Both the adult and the charged been abused and or children who are neglected affected
Gender of Adult or Majority males Majority females Majority females Parent
Type of Proceeding Criminal Civil (Parent may face All are civil, but some (Civil or Criminal) criminal charges in may also be criminal another court) Comprehensive The treatment, The health, safety, The health, safety, Assessment skill-training, and developmental and developmental developmental, and needs of each child needs of each child health needs of the are assessed. are assessed. The parent are assessed. treatment, skill-training, developmental, and health needs of the parent are assessed.
Family Involvement Nuclear and extended Extended family helps The spouse, family members are provide care and significant other, or often included in the supervision of father figure is often case plan. children. involved in the treatment process. Extended family is included in the case plan as appropriate.
9 Traditional Family Dependency Adult Drug Court Dependency Court Treatment Court Treatment Parent- or adult- Children are provided Treatment focuses on focused treatment if the parent but is also appropriate. extended to the Treatment of parent children, who are at may be required by risk for substance the court but abuse, mental illness, occasionally is not developmental provided through nor disabilities. Treatment supervised by the may be provided to court. the family as a unit.
Services Parent-/adult-focused; Children receive The family unit family unit may also services. Parent may receives a full range be referred for be referred to of services. Services services. services. for the parent and children are comprehensive and include areas such as parenting skills, domestic violence counseling, health care, and developmentally appropriate services.
Sanctions Parent-/adult-focused Not applicable. The Accountability is child is not focused on the parent. sanctioned. The court must Accountability is consider the impact of focused on the parent. a parent sanction on the children and family as a unit.
10 Traditional Family Dependency Adult Drug Court Dependency Court Treatment Court Role of the Judge Leader of a team; Determine best Leader of a team; therapeutic interest of the nurturing with children; leader of a children; therapeutic team Objectives Adult sobriety and A safe and permanent A safe and permanent reduced recidivism placement for the placement for children children through parent sobriety and the development of the skills and knowledge needed to become mature, responsible parents who can meet their children’s developmental needs.
Role of Agencies and Team members who Representatives of Team members who Organizations represent criminal various entities (in represent social justice and treatment traditional roles) services, treatment, services who are and justice (criminal empowered with or civil) who are increased empowered with accountability increased accountability and decisionmaking capacity Time Constraints Length of the program Movement toward Movement toward and treatment protocol safety and safety and permanency as permanency as mandated by the mandated by ASFA Adoption and Safe Families Act (ASFA) Review Hearings Frequent and As scheduled on court Frequent and regularly scheduled docket, mandated by regularly scheduled (varies from monthly state or federal (varies from monthly to weekly) statutes, or as needed to weekly) in emergency situations Drug Testing Frequent and random Drug testing done as Frequent and random drug testing of parents ordered drug testing of parents
11 Chapter 3 Common Characteristics of Four Early Family Dependency Treatment Courts
As discussions progressed during the 2-day focus group, participants identified characteristics shared by their programs. These are described below with notes about how each characteristic manifests itself in the progression from planning, through implementation, to the ongoing operation of the FDTC. Some descriptions are accompanied by program examples.
The first family dependency treatment drug courts—
• Integrated a focus on the permanency, safety, and welfare of abused and neglected children with the needs of the parents.
• Intervened early to involve parents in developmentally appropriate, comprehensive services with increased judicial supervision.
• Adopted a holistic approach to strengthening family function.
• Used individualized case planning based on comprehensive assessment.
• Ensured legal rights, advocacy, and confidentiality for parents and children.
• Scheduled regular staffings and judicial court reviews
• Implemented a system of graduated sanctions and incentives.
• Operated within the mandates of the Adoption and Safe Families Act (ASFA) of 1997 and the Indian Child Welfare Act of 1979.
• Relied on judicial leadership for both planning and implementing the court.
• Made a commitment to measuring program outcomes.
• Planned for program sustainability.
• Strived to work as a collaborative, nonadversarial team supported by cross training.
• Integrated a focus on the permanency, safety, and welfare of abused and neglected children and the needs of their parents.
For most substance abuse programs, the adult is considered the primary client. Treatment providers focus on the adult in their therapeutic activities and although they may engage the family in the treatment process, treatment providers do not consider the interests of the children as a primary concern.
12 In contrast, the child is the primary focus of the intervention for the child welfare agency. Although the entire family may be “before the court,” the child welfare specialist is required to put the child’s need for safety and permanency first when a choice must be made in balancing children’s needs and parents’ needs.
A family dependency treatment court integrates the needs of both children and parents, encompassing the entire family as the client. Although decisions are always made in the best interest of the child, the court maintains a parallel focus on the interests of the parent. The operating procedures and decisions of the court reflect this dual focus. The court provides parents with an opportunity to address the issues in their lives—primarily substance abuse, sobriety, and recovery—and clears the way for them to establish a permanent, safe, and nurturing home environment. Family reunification is contingent on the parents’ demonstrated ability to provide for the child’s health, safety, and well-being. Timelines mandated by ASFA must be recognized and adhered to by the team throughout the life of a case.
• Intervened early to involve parents in developmentally appropriate, comprehensive services with increased judicial supervision.
To meet the needs of parents, all of the first FDTCs intervened early to place parents in structured programs that included substance abuse treatment (often for 12 months), frequent court appearances, and drug testing; and training, education, counseling, and other ancillary services selected to meet each parent’s specific developmental needs.
The focus group identified two major challenges in providing these services to parents. First, the chronic shortage of treatment services—especially those for women and children—is a significant issue for all family dependency treatment courts. Participants noted that the shortage may get worse with the emergence of managed care. Because access to immediate treatment is a core tenet of FDTC, each court represented at the focus group had found a way to ensure that this treatment was available to its parents. (See sidebar for specific examples of how this was accomplished.)
The second issue noted by the focus group was the conflict in timelines between substance abuse treatment programs and state and federal statutory mandates related to child welfare. Because relapse is common for a substance abusing parent, the long-term timeframes needed for recovery may not mesh with the shorter timelines mandated by statute and used by child welfare agencies to make child placement decisions. As a result, the child’s needs for a permanent, safe home may conflict with the parent’s need for extended treatment. It may be difficult for the child welfare professional to determine whether a parent is making appropriate progress in treatment.
To reconcile these conflicting timelines, the FDTC coordinates treatment for parents with the deadlines for decisions about the placement of children. Through close ongoing communication among service providers, the court assesses the parent’s response to treatment and ancillary services to make timely decisions in the best interest of the child.
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Treatment for Parents: Examples From the First FDTC Programs
San Diego, California
To give its clients more immediate access to treatment, the FDTC in San Diego contracted for priority slots in San Diego County’s network of alcohol and drug treatment providers. This initiative was funded through the San Diego County Board of Supervisors and the Alcohol and Drug Services Division of San Diego’s Health and Human Services Agency.
Reno, Nevada
The Reno court has both an outpatient track and an inpatient track in which parents sometimes live with their children. Outpatient services are funded through a contract with the department of social services in addition to grants and donations. Inpatient services are funded through fees charged to participants on a sliding scale and supplemented by grants and donations.
Suffolk County, New York
The Suffolk County court uses existing community-based nonprofit and for-profit treatment facilities licensed by the New York State Office of Alcohol and Substance Services. Treatment modalities include an array of services: detoxification, short-term inpatient, long-term residential, day treatment, intensive outpatient, and outpatient. Treatment is provided by approximately 30 nonprofit agencies under contracts managed by the Suffolk County Department of Health, the Division of Community Mental Hygiene, Alcohol and Substance Abuse Services. This managing agency also serves as liaison between the treatment community and the family treatment court.
Kansas City, Missouri
The Kansas City program is specifically geared toward mothers and infants who have been exposed to drugs. Treatment, both residential and outpatient, is provided through an agency specializing in the services needed by this group. Funding may come through Medicaid, private insurance, or self payment on a sliding fee scale; it can be Community-Backed Anti- Drug Tax (COMBAT)-assisted; or it may be provided by the Missouri Department of Mental Health. The provider, a C-Star model for comprehensive services, has a noncompetitive contract but must offer an informal bid that binds it to the level of participation and collaboration required by the court. All needed services must be available to any participant accepted into the program.
14 • Adopted a holistic approach to strengthening family function.
Many children and parents have specialized needs that affect their ability to thrive in an FDTC program. For example:
o Children and parents with developmental disabilities may need the support of team members who are trained to work with the specific challenges of these conditions.
o Children and parents with co-occurring mental health, substance abuse, and developmental disorders will need appropriate services to succeed in the program.
o Women with histories of sexual abuse may be more comfortable in court if they can talk to a female judicial officer.
o Parents diagnosed with HIV need additional medical services, and their children need a long-term permanency plan as well as a short-term plan.
Domestic violence, in particular, presents numerous challenges to FDTCs. Many women and children coming into the courts are the victims of domestic violence—or have a significant other who is also involved with alcohol or drugs. In response, many courts have the authority to hold a significant other accountable. In some courts, this accountability is achieved through a signed contract requiring that the significant other comply with the court’s conditions. Other courts may make a significant other’s contact with the children contingent on program participation.
In many cases, the FDTC’s ability to respond to a family’s special needs can mean the difference between success and failure. Unfortunately, the appropriate services are not always available. To implement a holistic approach to strengthening the family, the team must actively seek out resources to respond to these needs.
“As a caseworker for the family dependency treatment court, you move furniture, take people to appointments, do whatever needs to be done. You work harder and provide more intensive services, but it’s more rewarding because you’re seeing success. You’re more invested and have more information to work with because of communication with the team. The more contact you have with the family, the more success you see.”
—Child Welfare Specialist Family Dependency Treatment Court Reno, Nevada
15 • Used individualized case planning based on a comprehensive assessment.
Both the children and the parents of each family entering an FDTC receive a comprehensive assessment to determine their developmental, mental, and physical health needs and their treatment. With this information, the team customizes a case plan to meet the family’s needs, drawing on relevant disciplines and specialties.
Program Example: Kansas City
The Jackson County Family Dependency Treatment Court, which is designed to serve women with infants who have been exposed to drugs, intervenes after birth while mothers are still in the hospital. A social worker with a background in substance abuse conducts a crisis assessment of both mothers and newborns who have been identified by hospital staff as substance dependent. This immediate assessment helps the team determine how the case should be handled. By collaborating with hospital staff to develop the protocols for testing mothers and their newborns, the program has fostered good working relationships with staff members and heightened their concern for drug-exposed infants. Team members report that children clearly benefit from this cooperative, early intervention approach.
The Jackson County program has the backing of the Metropolitan Task Force on Drug-Exposed Infants. The task force is a long-standing workgroup that has met monthly for 10 years in Kansas City. This multidisciplinary team routinely reviews local issues and has spearheaded local and state system reforms.
The focus group devoted special attention to two components of an effective case plan: parenting programs and aftercare.
Parenting programs. Many types of parenting programs (sometimes called family-strengthening programs) are available to address a range of problems. Since 1990, the U.S. Department of Justice has funded efforts to synthesize research and practice information on these programs for wider use in the field. After reviewing 500 nominated programs, researchers selected the top 25 on the basis of evaluation results and ease of dissemination (Office of Juvenile Justice and Delinquency Prevention, 1994). (Several interventions that may fit within the FDTC model are described in appendix D.)
Typically, parenting programs define family as the constellation of adults or siblings who care for a child. Nontraditional family arrangements include single-parent families, divorced families with joint custody of the child, children living with extended family members, adoptive parents, protective custody (such as temporary or permanent foster homes), and stepparents (sometimes in blended families with children from two or more prior relationships).
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Program Example: Miami
The Miami Dependency Drug Court, Family Dependency Treatment Court Initiative, implemented a family-strengthening curriculum that combines two proven family-focused interventions: Ages and Stages, which assesses children ages 0 to 4 for developmental delays; and Strengthening Families, which uses an adult/child/family systems approach for responding to family problems and improving chances for reunification. (A description can be found in appendix D.)
Aftercare. Aftercare is a complex issue when substance abuse treatment is provided in a civil justice setting—and even more complex when child abuse and neglect enter the picture. The FDTC team needs to devise strategies to prevent relapse, and they need to plan for child safety if relapse occurs. Because the risk of relapse is most likely during the first 3 months following treatment, it is recommended that child welfare officials continue monitoring families for at least 3 months after a parent leaves treatment and regains custody of the children. Although many child welfare officials say they cannot afford such support, it has been noted that they are already providing this followup by repeatedly reopening cases that have closed. Given the chronic nature of substance abuse, this cycle is likely to repeat itself many times if effective aftercare is not provided (National Center on Addiction and Substance Abuse, 1999).
Aftercare is a critical component of FDTC programs because there is always a danger that a parent will relapse and jeopardize the well-being of the child. Many parents are aware of their need for ongoing support. In fact, personal communication with a judge revealed that parents sometimes intentionally sabotage their graduation so they will not be left without services.
Providing for aftercare can be a challenge to the FDTC team, especially as time passes and the parents are no longer under the jurisdiction of the court. To ensure that resources are in place by the time of graduation, planning for aftercare should begin when the family first enters the program. The parent will need routine access to self-help groups, counseling sessions, and possibly other resources such as alumni events, support groups, and social functions.
The aftercare plan should also maintain services for children who may have been maltreated for a substantial period of time. When the plan addresses the needs of both the parent and the child, aftercare contributes to a healthy reunification process, growth of the family, and a permanent placement for the child.
• Ensured legal rights, advocacy, and confidentiality for parents and children.
Each member of the FDTC team must ensure that advocacy, confidentiality, and due process are maintained by advising the parents, children, and their representatives of the guidelines for participating in the drug court. Because parents are subject to sanctions by the court, it is essential that they be oriented to the conditions of participation. Some
17 judges use the jail sanction in an FDTC. In this situation, it is important that parents be notified upon entering the program that a jail sanction could be levied, and that they agree, in writing, to accept such a sanction.
The court should orient and provide written materials to participants and their families advising them of their rights and resources for advocacy.
Program Example: Suffolk County, New York
In Suffolk County, the obligation to be drug free is stated in a court order. Based on the facts of a particular event, the judge may find that the order was violated and then impose the jail sanction. The parent has an opportunity to know what the evidence is—usually a positive urinalysis—and to give an explanation before the judge makes a decision.
• Scheduled regular staffings and judicial court review.
FDTC teams hold frequent staffings to review the progress of each child and parent and to update family case plans.
Victims of child abuse and neglect come before juvenile and family court judges for protection from further harm and for timely decisionmaking for their future. In response, judges make critical legal decisions and oversee social service efforts to rehabilitate and maintain families, or to provide permanent alternative care for child victims. Frequent judicial review of cases in the FDTC—preceded by a team meeting (often called a staffing)—is an important component of the court’s process. This is the opportunity for team members to give the judge vital information that will ensure that his or her decisions are based both on up-to-date assessments of the progress of parents and on the well-being and safety of their children.
In the past, it has not been a standard requirement for a judge to build partnerships with other service providers or to develop nurturing relationships with the people who come into the court system. However, the FDTC’s team approach changes those relationships. Participating judges, child welfare and substance abuse treatment systems, social service agencies, attorneys, law enforcement officials, and community groups all must become familiar with program policies and procedures, treatment procedures and issues, judicial system processes, and the mandates and legal issues affecting parents and children. Many issues must be resolved among the various disciplines to conduct effective meetings and make key decisions in response to parental compliance with court-ordered case plans. In some FDTCs, decisions about visitation and services for children are made during staffing hearings; in other courts, these decisions are made in separate child protection proceedings. If separate dependency proceedings occur, close coordination with the FDTC should take place.
18 Frequent judicial oversight of parents’ progress in substance abuse treatment, compliance with conditions of court orders, and relationship and interaction with their children is a necessity to the FDTC process. Although the judge is considered the leader in the process, it is imperative that team members recognize that their knowledge and expertise can enhance the judge’s ability to manage families in FDTC through staffing and court hearings.
Some courts allow children in the courtroom. The effort to create an atmosphere in the court that is welcoming to children is integral. The judges participating in the focus group described child-friendly courtrooms that include benches just for children. The children can work on puzzles, color with crayons, and play on the floor, or a court clerk may have a candy drawer with treats for the children. In this type of setting, children see the courtroom not as a scary place, but as a place that can help their families.
• Implemented graduated sanctions and incentives.
FDTCs hold parents accountable through a graduated system of sanctions and incentives.
Sanctions are used as a consequence for parents who miss a hearing date, test positive for drugs, skip a treatment session, or are otherwise noncompliant. Incentives are used to reward parents who achieve program milestones or perform admirably in the program. Practitioners generally agree that both sanctions and incentives have a therapeutic impact on parents and help them accept responsibility for their actions.
Sanctions and incentives are also the key elements of the adult drug court model. In the adult court, the primary focus is on the adult offender. Therefore, when issuing sanctions, the judge needs to consider only the appropriateness of the sanction to the action and any written guidelines of the court.
FDTC sanctions might include verbal admonitions from the judge, therapeutic essay writing, community service, fines, and increased frequency of urine testing. For significant acts of noncompliance, a judge may order an offender to jail for 2 days, a week, or longer. However, when considering a jail sentence for the parent, the FDTC first considers how this sanction might affect the safety and welfare of the children; every effort is made to avoid adverse effects. Jail time should not conflict with the parent's time with the child, even if the child is in foster care.
The effect a parent’s jail time has on children is just one of the serious issues this sanction raises for FDTCs. The other is due process. In the adult drug court, defendants must sign a contract—as a condition of entry to the program—acknowledging that jail is one of the sanctions for violating the program requirements. In doing so, defendants waive their right to advance notice and a full hearing prior to being jailed. This mechanism enables the judge to swiftly impose the sanction when necessary. Although this practice has been challenged, it still is the way most adult drug courts operate.
19 The Use of Jail as a Sanction: Focus Group’s Perspectives
Focus group participants expressed varying opinions about the value of jail time as an FDTC sanction.
The Reno team reported that its judge sees a 48-hour jail stay as very motivating. In San Diego, jail time is used for parents who show a pattern of noncompliance over time. (In both jurisdictions, the incarcerated parent continues to receive treatment while in jail.)
Both the Reno and San Diego teams argued that jail time gets the attention of the parent very quickly—an advantage given the stringent time constraints of ASFA. Jail time also makes clear the seriousness of illegal drug use and forces parents to consider its detrimental effects on their children. Finally, they argued that parents in the courtroom who see another noncompliant parent go to jail are forewarned and may, in turn, take their responsibilities more seriously.
The majority of focus group participants agreed that there may be times when jail is an appropriate sanction. They pointed out that not all children are hurt by the sanction, and many parents learn a valuable lesson. The group concluded, however, that the welfare of the child should always be considered before a jail sanction is issued.
A dissenting opinion was voiced by participants from the Jackson County program. There, jail time is seen as demeaning to women in the program and detrimental to children who, when they see a parent being taken away, may perceive that they, the children, are being punished.
Program Example: Suffolk County Sanctions and Incentives—Levels and Phases of Dependency
Treatment courts often have written guidelines to govern the judge’s issuance of sanctions and incentives. The guidelines shown in table 2 are used by the Suffolk County, New York, family court. The most serious infractions—Levels A and B—require an immediate court appearance, reevaluation of contact with children, and reassessment of the treatment level. In some cases, Level C infractions may result in more severe sanctions.
20 Table 2. Consequences and Rewards for FDTC Parents in Suffolk County, New York Infraction Sanction Level A Leaving treatment with involuntary return Reduction in phase to court Violating a protection order Termination from program Filing of a new petition Up to 6 months in jail Level B Leaving treatment with voluntary return to Reduction in phase court Tampering with urine Up to 2 full days in court, termination from program, up to 6 months in jail Level C Testing positive or missing drug test Reprimand from court Missing treatment appointment Therapeutic essay Missing visit with child Increased court appearances Missing appointment for services One or more full days in jail Failing to keep recertification appointments Increased case management contacts
Arriving late to court, breaking treatment Increased case management contacts program rules Achievements Incentives 30 days clean Acknowledgment by judge Complying with court order Reduced court appearances, case called early in court, small gift (book, keychain)
Completion of Phase I Phase Advancement Reward 4 months clean Acknowledgment by judge Complying with court order Case called early in court, small gift
Completion of Phase II Phase Advancement Reward
4 to 6 months clean Acknowledgment by judge, case called early in court, small gift
Completion of Phase III Graduation Ceremony 6 months clean Certificate of completion
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• Operated within the federal mandates of the Adoption and Safe Families Act and Indian Child Welfare Act.
The Adoption and Safe Families Act of 1997 (Public Law 105-89) was passed in response to the overwhelming number of children in the foster care system without permanent stable families and the pressing need to change how families that abuse or neglect their children are dealt with. The Indian Child Welfare Act of 1979 specifies procedures for state courts to follow in custody proceedings for Native American children identified as abused or neglected.
Adults and children experience the passage of time very differently—physically, developmentally, and emotionally. An adult may be equipped to wait for an uncertain situation to resolve itself sometime in the future; however, a child’s time is now. In recognition of the child’s differing sense of time, ASFA reduces the deadline for permanency placement hearings for children in foster care from 18 months to 12 months.
In dependency cases involving parental substance abuse, ASFA has made evident both the lack of access to treatment for substance abusing parents and the disconnects among courts, caseworkers, and treatment services—problems that often result in children continuing to live in unsafe conditions or in foster care placements for protracted periods of time. In some cases, this lack of service access and coordination for substance abusing parents has contributed to the termination of their parental rights.
For the FDTC, the shortened timelines under ASFA mean that parents with substance abuse problems have much less time to enroll and participate in treatment and to demonstrate their capacity to provide a safe home for their children. The FDTC must operate within these constraints.
The FDTC team—which includes many professional disciplines—brings a unique perspective to the issues surrounding the implementation of ASFA. FDTCs offer valuable insight regarding the protection of children and ideas to more effectively move the dependency court population through the FDTC process. The provisions of ASFA—and their full implications for the family dependency treatment court—are explored in greater depth in chapter 6.
• Relied on judicial leadership for both the planning and implementation of the court.
The judge plays a key leadership role in the planning and implementation of an FDTC, encouraging team members to collaborate as they express their professional opinions. To be prepared for this leadership role, judges need training on the nature of substance abuse and recovery. They may also need orientation to the team approach—that is, the ways collaboration with other service systems can result in recovery for parents, reunification of families, and timely placements for children. The role of the judge is described further in chapter 5.
22 • Made a commitment to measuring outcomes of the FDTC program.
Focus group participants agreed that ongoing evaluation is essential to FDTC success because it helps jurisdictions answer questions such as:
o Is the program accomplishing what it intended to do? Is it meeting its goals and objectives?
o Which components are effective? Which are not?
o Is the program reaching its target audience?
o Which services are most appropriate and useful for participants?
o Is there a need to hire more staff?
By documenting the positive outcomes for children and families, evaluation results can be used to gain support for FDTCs from policymakers and elected officials, and to change laws and policies to enable the expansion of FDTCs to and increase their acceptance in the community.
The first step in planning an evaluation is to define success by asking “What is a successful outcome?” or “How will we recognize success?” The answer differs depending on the perspective of the practitioner. From the perspective of substance abuse treatment, successful outcomes are measured, in part, by the cessation of alcohol and drug use, decreased criminal behavior, and decreased need for health services. However, from the perspective of the child welfare agency, the child’s safety and the permanency of the child's successful placement in the home define success. At times these definitions may be difficult to reconcile because, even when the parent’s treatment goals have been met, child safety issues may remain.
At the inception of the FDTC program, the team needs to develop a common definition of success. Using this as a starting point, it then should identify the variables to be studied and establish procedures to ensure the efficient and timely gathering of data. The evaluation should also be tailored to answer the questions of stakeholders who have decisionmaking power. When external evaluators are used, practitioners should become involved in the research design and methodology by providing information about the program’s content and background (Tauber and Snavely, 1999).
Beyond its benefits to individual programs, the accumulation of evaluation findings also benefits the field as a whole. In a review of FDTCs, the Urban Institute (1999) recommended a number of areas in which preliminary research is both needed and feasible in existing FDTCs. Those recommendations are presented in appendix C. Preliminary studies, such as those recommended by the Urban Institute, will lay the groundwork for more sophisticated studies on the larger impact of FDTCs. Future studies
23 should assess the long-term effects of the FDTC approach on child well-being and parent functioning in a range of life domains. Impact evaluations also need to be conducted to determine the effectiveness of specific service components and to identify the characteristics of cases most likely to benefit from the FDTC approach.
• Planned for program sustainability.
Funding sources for FDTCs are limited. In some jurisdictions, a “tough-on-crime” stance narrows access to the available sources. In others, managed care constraints limit certain types of services. (In Jackson County, for example, inpatient days are severely curtailed.)
However, focus group participants pointed out that FDTCs are not limited to moneys raised within the community. Program support can also come through nonmonetary resources and the reallocation of resources within communities. In addition, the group noted several important opportunities for states and local communities to expand treatment services for parents through the child welfare system. The following strategies were identified during the focus group meeting:
o The Substance Abuse Prevention and Treatment Block Grant, managed by SAMHSA, is the largest source of treatment funding. This block grant to states provides funds for substance-abuse prevention and treatment services.
o When treatment capacity is insufficient for a particular population (such as women and children), state and local agencies can apply for discretionary funds from SAMHSA’s Targeted Capacity Expansion Program.
o A number of states have expanded the provision of substance abuse treatment services through Medicaid in recent years. Additional states may want to consider this option as a way of expanding treatment capacity. Many child welfare parents are already eligible for Medicaid.
o Some substance-abuse services can be paid for under Temporary Assistance for Needy Families (TANF) and welfare-to-work programs. Many families in the child welfare system with substance abuse problems receive welfare benefits. If parents’ substance abuse interferes with their ability to care for their children, it may also interfere with their ability to work. States and counties can incorporate substance abuse treatment services as part of their parents’ employment plans. Under these circumstances, TANF and welfare-to-work funds can be used for nonmedical aspects of substance abuse treatment if it is not otherwise available. 1
o The Administration for Children and Families is the lead agency in the U.S. Department of Health and Human Services for programs that promote the economic and social well-being of families, children, individuals, and communities. Different types of funding include the Court Improvement Program (a grant program to help state courts improve their handling of proceedings related to foster care and adoption), child abuse and neglect programs (a grant
24 program to help states improve and increase prevention and treatment activities), community service block grants (a grant program that provides states, territories, and Indian tribes with a flexible source of funding to help reduce poverty and address employment, education, housing assistance, energy, and health services), individual development accounts (a new program that empowers low-income individuals to save money for a home), social services research, and the Low- Income Home Energy Assistance Program.
o Title XX of the Social Security Act, also called the Social Services Block Grant, is a capped entitlement program. Block grant funds are given to states to help them achieve a wide range of social policy goals. Funds are allocated on the basis of population.
These resources may help FDTCs expand treatment capacity at the state and local levels. At the same time, programs can educate state and local leaders about the value of FDTC programs and urge them to expand resources to address the needs of children and parents involved in the child welfare system.
• Strived to work as a collaborative, nonadversarial team supported by cross training.
Substance abusing parents are more likely to succeed when services are provided in a seamless, well-coordinated continuum. To achieve this, the FDTC teams represented at the focus group all strived to establish a nonadversarial, team-oriented environment. Teamwork enabled them to communicate with parents in one voice, thereby eliminating the confusion of contradictory messages, strengthening the relationship between the court and the family, and fostering the parent’s motivation to change.
However, the operation of an FDTC requires the efforts of individuals from a number of agencies—many of which have a history of unresolved turf issues and difficulties working in collaborative ventures. To create the nonadversarial, collaborative environment that is the foundation of effective teamwork, the FDTC must address the different philosophies and approaches that have traditionally separated the fields of substance abuse treatment, child welfare, and the judiciary. Every party in the FDTC system must step outside his or her traditional role, assume additional responsibilities, work harder and faster, and embrace perspectives he or she may not have considered previously. Some of the difficulties encountered in making these changes include:
o Judges who reject the FDTC philosophy because they do not want to take on responsibilities that have traditionally been viewed as beyond the scope of judicial authority.
o Substance abuse treatment providers who fear that parents will be taken out of treatment against their wishes and put in jail.
o Child protective services caseworkers who are overwhelmed by additional demands and the close scrutiny of the multisystemic team
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o Members of the substance abuse treatment community who see ASFA timelines as a threat and who need a better understanding of the FDTC system.
o Parent advocates and defense attorneys who fear the parents are not granted due process and who may encourage the parents not to cooperate.
o Child attorneys or representatives who worry that decisionmaking will focus more on the parent than on the child, that reunification will be rushed, and that visitation will be used as a sanction or incentive.
Although all these fields share the vision of permanent recovery for parents and permanent placement for children, safety for children, and healthy, functioning families, their differences have the potential to create misunderstandings, engender mistrust, and undermine cooperation. Each field has its own definition of who the client is, what outcomes are expected, what the timeline should be, and the appropriate response to setbacks. In addition, the legal and policy environments in which the agencies operate also affect their ability and willingness to work together. These environments are shaped by state and federal laws on child abuse and neglect, the sense of crisis under which many child welfare agencies work, the chronic shortages of substance abuse treatment services, and the confidentiality requirements that may prevent sharing information (Administration for Children and Families and the Substance Abuse and Mental Health Services Administration, 1999).
Focus group participants agreed that one of the best ways to bridge the gaps among those involved in the FDTC is to implement cross-system training. Their experience is supported by a paper from the National Center on Addiction and Substance Abuse (1999) at Columbia University, which recommends that certification and licensing of child welfare officials include training in the nature and detection of substance abuse and what to do when it is found. The report also states that judges and child welfare directors need to accept responsibility for training themselves and their staffs about the substance abuse problems that are driving their caseloads and about confidentiality laws for persons receiving treatment.
Cross training is also critical for substance abuse treatment providers. For many of these providers, participating in the legal arena may be a new experience. They need training in the court process, especially concerning open communication and frequent contact with the court. They must also become versed in the court’s legal mandates—from both ASFA and the Indian Child Welfare Act. They also need orientation to the perspective of “the family as the client” with the best interest of the child as the paramount concern—a perspective that is not the traditional view of the treatment provider.
26 But cross training does more than impart information. It also helps build relationships and trust among team members. As a supplement to regular staffings, it allows time to discuss program procedures, identify gaps in service, consider how to improve outcomes for families in the program, and resolve problems as they develop.
Program Examples: Suffolk County, Reno, San Diego
Suffolk County, New York
To bridge the systemic barriers between substance abuse treatment and child welfare, the Suffolk county family treatment court develops a comprehensive service plan for each case, with input from both substance abuse treatment providers and child welfare representatives. The plan includes specific goals to meet the treatment needs of the parents and the service needs of the children. The team ensures speedy alcohol and drug assessment of the parents and identifies barriers to treatment. The members of child protective services conduct a risk assessment. A court-appointed special advocate is appointed for each child. The entire team reviews the service plan for consistency. The primary goal is preserving or reuniting the family and developing a permanency plan for the children.
Reno, Nevada
In Reno, substance abuse treatment efforts have improved because of the FDTC, where the individual issues of parents and their children are taken into consideration. The children benefit from the services received by their parents, such as intensified parenting classes, referrals to domestic violence centers, and sexual abuse treatment. Efforts are made to provide a variety of services in one location (one-stop shopping) to make it easier for the mothers. Rather than focusing only on getting the mother off drugs, the court also ensures that the needs of the children are met.
San Diego, California
In the San Diego court, the substance abuse treatment plan becomes part of the reunification plan, and representatives of all systems work toward the same goals. The social workers have a significant role in ensuring that services are delivered, and they work closely with the county-contracted Substance Abuse Recovery Management System (SARMS) recovery specialists (i.e., parents’ substance abuse case managers who work with the treatment program under contract with the county).
Despite significant barriers to collaborative teamwork, many opportunities to more effectively serve families result from the shift in roles. Professionals in all systems have the opportunity to learn from one another and resolve turf issues. Therefore, it is necessary to train practitioners in ways that help them carry out these new responsibilities.
27 Chapter 4 Varying Approaches
Among jurisdictions across the country, the family dependency treatment court approach varies in a number of ways. The differences may result from a number of factors: the statutory framework within the state and local jurisdiction, the availability of resources, the degree of community support, the infrastructure of the local jurisdiction, and the ease of collaboration among systems. Below are five examples of how FDTCs may vary in their approach:
• Type of case. Most FDTCs accept only clients with civil cases. A few handle clients with both civil and criminal cases.
• Court of jurisdiction. FDTCs may operate under the jurisdiction of the family court, the juvenile court, or the general jurisdiction court.
• Infrastructure of the local judicial jurisdiction. Some FDTCs use a “one family, one judge” approach; all pending cases involving any member of the family are consolidated under the oversight of the FDTC judge. In other programs, families may deal with multiple judges—from the dependency court, the FDTC, and other criminal and civil courts in which family members may have matters pending.
• Integrated or supplemental program. Some FDTCs are fully integrated within dependency court. Other programs supplement the dependency court case process and step in at a particular point in the process to review parental compliance with court orders.
• Target population. Some programs focus on specific populations, such as mothers of drug-exposed infants. Others have a much wider focus and will consider any dependency case in which the initial investigation determines that parental substance abuse contributes to the abuse or neglect of children.
Each of the FDTCs represented at the focus group has its own individual approach, which is illustrated in the following overviews. For detailed descriptions of the focus group courts, see appendix A.
Suffolk County, New York
New York’s Suffolk County Family Treatment Court enhances child protective services by providing case processing within civil family court proceedings and accepting cases of child neglect (but not child abuse) resulting from parental substance abuse. The family treatment court was developed in response to the escalating number of neglect cases involving parental substance abuse and the need to better integrate and coordinate services for children and families. The enhanced services offered by the program support the efforts of the department of social services by developing comprehensive service plans, facilitating access to treatment and ancillary services, and providing increased judicial monitoring of cases. The family treatment
28 court is designed to integrate chemical dependency and child welfare services for drug-addicted parents and their children.
The judge hears family treatment court cases on a separate docket—two mornings and three afternoons a week—and is assisted with monitoring and review by the treatment court team. Court staff members work jointly with members of a multidisciplinary case management team consisting of case managers, a court-appointed special advocate, drug and alcohol abuse specialists, and a liaison from the department of social services. The program provides a wide range of services to families, including parenting skills, mental health services, counseling on domestic violence issues, public health nursing services, and substance abuse treatment.
Reno, Nevada
The Reno court is an example of a program that works with both cases involving criminally charged parents and cases of child removal due to abuse or neglect. Respondents who appear before the family dependency treatment court judge are mostly women with substance abuse problems. The program provides for a minimum of 1 year of substance abuse treatment, linkage to social services, and a drug court team consisting of the judge, his or her staff, a case manager, the treatment provider, and a child welfare caseworker. Other team members may include the prosecutor, defense counsel, and probation officer. The program has uniquely used foster grandparents in a number of cases to provide support for the children and parent during their participation.
Jackson County (Kansas City), Missouri
The family dependency treatment court in the Sixteenth Judicial Circuit Court of Jackson County, Missouri, handles child abuse and neglect and other child endangerment cases. The court works directly with hospitals that identify new mothers who are substance abusers, and the program attempts to keep new mothers with their babies to ensure the critical early bonding of the newborns can take hold. Program proponents believe that the unique needs of each stage of child development must be met to protect the emotional stability of the child. Therefore, courts must move quickly to provide either a safe home with the parent or a stable and permanent living environment outside the parent’s home. Delays in permanency decisions or frequent changes in placement can cause irreparable psychological damage to the child. To achieve these goals, the court works to stop substance abuse by parents when the substance abuse threatens the safety and welfare of their children. The court provides supervision and specialized treatment to parents who are abusing substances, led by a team that specializes in dependency cases.
San Diego County, California
The two-tiered approach used in the Dependency Court Recovery Project in San Diego County provides court supervision and substance abuse treatment through seven traditional dependency courts and three dependency drug courts. The dependency drug courts provide intensive supervision for parents who fail to comply with the requirements of the traditional dependency court. All parents who come before the traditional dependency court with evidence of an alcohol or drug abuse problem are screened and assessed for substance abuse. Any resulting treatment
29 plan becomes part of a court order, and violation of the court order results in escalating sanctions. The third occurrence of noncompliance may result in transfer to the dependency drug court, an intensified three-phase program of treatment with heightened supervision and judicial monitoring (each phase lasts 90 days). If the parent still does not meet treatment goals, a hearing to terminate his or her parental rights may be held. San Diego’s program was developed in response to the estimated 80 to 90 percent of parents who come before the dependency court with substance abuse problems.
30 Chapter 5 Community Stakeholders
“Stakeholders have a vested interest in the success of the family dependency treatment court and are likely to include parents, abused and neglected children, extended family members, judges, other members of the judiciary, prosecutors, defense attorneys, police and probation officers, jail administrators, public health practitioners, ancillary service providers, child protective service providers, school officials, transportation and daycare providers, employment and training specialists, welfare-to-work program specialists, local labor department officials, faith community leaders, county council members, State legislators, health care professionals, and the media.”
—Focus Group
Good processes and viable programs are important to the success of an FDTC. Equally important are the people who plan the processes and programs, support them, and participate in them. The focus group identified three groups of stakeholders who are critical to the success of their courts:
• Members of the steering committee. • FDTC team members. • Families appearing before the court.
This section specifies the key people and entities that need to be engaged in the work of an FDTC and describes the roles of principal team members. It also discusses the identification of a target population and offers a profile of the parent most often seen in an FDTC.
Steering Committee
Each of the focus group court teams identified a committee of key stakeholders, often organized at the inception of the project, as a steering committee. All the teams indicated that the support of their steering committee significantly contributed to their success. The list of key decisionmakers and community stakeholders is likely to vary from one community to another. Common to most of the lists are top-level officials and decisionmakers, treatment and ancillary service providers, policymakers, and community members.
The steering committee facilitates support for the drug court concept among high-level policymakers (e.g., elected prosecutor, presiding judge, and chief public defender) and commitment to supporting successful outcomes. In this manner, the planning team, which may include nonexecutive-level personnel, will be confident that the head of each participating agency has made the FDTC a priority, and has delegated to the team the authority to make implementation decisions. The steering committee should have as its clear purpose the support
31 and operation of the FDTC. It should meet regularly and establish a procedure for ongoing communication with the planning team to provide oversight and support.
The steering committee should comprise executive-level personnel from each agency involved in or affected by the FDTC. Members from noncourt-related community entities should also be considered. These members should be selected for the political support or potential resources that they may offer in support of the FDTC’s planning process and operation. Potential members should reflect a broad cross section of the community. In this regard, members may include representatives of civic clubs (e.g., the Rotary Club or Lions Club), health agencies, local media outlets, vocational and educational services, the faith community, and private foundations.
At least two focus group teams noted that their steering committees have disbanded, and they urged other teams not to allow this to happen. Another court team supported this statement, pointing out that it has kept its steering committee in place and active throughout the life of the program, and that the committee has remained supportive and resourceful.
The FDTC Team
The purpose of the FDTC team is to ensure that every child’s and parent’s needs are met and that each receives every opportunity to be successful. Although each member of the FDTC team is accountable for his or her individual performance, team members work collectively, share critical information, and make collaborative decisions about every case before the court. Teams meet regularly—usually weekly—to share information regarding the children’s and parents’ progress, attendance at hearings, and participation in treatment. At these meetings, team members serve as sounding boards and listen closely to one another. Because the team is working together, no individual carries the entire burden for decisions that affect the family.
Team members often develop relationships with the parents and their children and observe every aspect of their lives. Therefore, each team member’s insight and observations are important in making decisions. The entire team (depending on the jurisdiction) is usually present at court hearings. This is important for the presentation of a consistent message, which prevents parents from manipulating individual team members and ensures parent accountability.
Although the makeup of the FDTC teams represented at the focus group varied slightly, some positions were considered essential. Descriptions of the key members of an FDTC team follow:
Judicial officer. The primary role of the judge in abuse and neglect cases is to ensure the child’s safety, permanency, and well-being. The judge oversees the progress of family members in treatment and serves as the team leader in bringing together various components of the program—including those within the family court system, the substance abuse treatment community, the child welfare system, mental health services, and other community organizations. The judge is also the central figure in the treatment and recovery of the participants, serving as a role model and authority figure to whom participants look for guidance and support. The judge provides leadership, and is in a position to influence related reform efforts and keep his or her colleagues and the community informed about the FDTC.
32 The judge is also obligated to educate team members and FDTC participants about courtroom policies, procedures, and the judge’s role. He or she should remain open to learning from other team members about their systems. It is especially important for the judge to understand the cycle of substance abuse and relapse in addition to the various treatment options available. Judges also need specialized knowledge of child development, family violence, and other child welfare-related issues, including services for children and families available in the community.
Coordinator. The FDTC coordinator is the “hub of the wheel.” He or she maintains the ongoing operation of program activities and ensures that the team works efficiently to provide services for the family. The coordinator is responsible for the overall monitoring services, ongoing scheduling of cases, maintenance of files, identifying and allocating resources, budgeting, and evaluating performance. The coordinator position may vary greatly from one jurisdiction to another. The scope of this position will be determined by the overall needs of the FDTC.
Substance abuse treatment providers. Treatment providers are critical to the success of the program and should be included in the program planning stage to help establish common goals, learn to “speak the language” of the child welfare and dependency court systems, and provide mechanisms for communicating the results of drug testing and other relevant information. It is the responsibility of the substance abuse professional to determine the appropriate substance abuse treatment and continuum of care for the parent and to educate the team on relevant issues regarding treatment modalities, relapse, and substances of abuse specific to their jurisdiction. In addition, treatment providers attend and participate in staffing and court sessions to offer information about the progress of FDTC participants.
Child welfare representative. Child welfare representatives are responsible primarily for the well-being of the children and are a key part of successful collaboration. Child welfare agencies and practitioners are responsible for protecting children’s health and safety, advocating on behalf of the children’s best interests, and ensuring that children and their parents receive necessary services in addition to substance abuse treatment. They, too, must learn to speak the language of the other team professionals, especially of substance abuse treatment providers, and understand substance abuse and the cycle of relapse and recovery.
Representative of supervision agencies. Those who function in a supervisory role, such as those in child protective services probation and parole officers, and treatment alternative to street crime (TASC) case managers maintain ongoing contact with the parents or offenders and provide frequent reports on their progress. This function is especially critical in linking offenders with community supervision, treatment, and law enforcement services.
Child attorney/representative (i.e. court-appointed special advocate and guardian ad litem). These separate legal representatives for children bring a necessary dynamic to the drug court team. They provide a voice for the children during the staffing hearing that might be absent in the general discussion. These attorneys often bring attention and focus to the needs of the children.
33 Parent attorney. The parent attorney ensures that the FDTC gives consideration to the parent's interests while at the same time guarding the welfare and safety of the child. This team member informs the parent about court procedures, makes the parent aware of the benefits of the program, and encourages the parent to participate. During team discussions of possible sanctions and incentives, the parent attorney may remind team members that in a family court setting, sanctions that separate a parent from a child are not always the answer. The parent attorney may also handle any related criminal charges against the parent.
Agency attorney/prosecuting attorney. The attorney responsible for bringing the case forward is integral in the identification of cases eligible for participation in the FDTC. The attorney attends all required hearings and files the motions and petitions necessary to initiate the parents’ involvement in the FDTC. In addition, the agency attorney attends and participates in the staffing and court hearings to ensure ASFA timelines are met and the safety and best interest of the child are maintained. The attorney monitors the dependency court case, regardless of whether the family dependency court is fully integrated within, or is separate from, the family dependency treatment court.
“Treatment providers have always been skeptical of how the court system treats clients. [It] has been focused on punitive measures that are intended to force people into socially appropriate behavior. As the treatment provider for the Kansas City Juvenile and Family Dependency Treatment Court, my perception has dramatically changed. We are witness to a system of attorneys, judges, and case managers who are passionately concerned about the welfare of our children. What makes this system so successful is a collaborative working relationship between the provider and the court. We are grateful for the opportunity to affect so many lives in a strength-based continuum of care.” —Carla Ingram, CSACII, LCSW Program Manager North Star Recovery Kansas City, Missouri
Family Members
The children, parents, and other family members are also stakeholders in the FDTC. In the FDTC setting, parents have more opportunities to advocate for services to meet the needs of their children. They have the opportunity to bring their concerns before the court or to speak individually to team members. Children have a voice through their social worker, parents, or representatives, or they may speak directly to the court regarding their own safety, well-being, and permanency.
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Program Example: Reno, Nevada
In Reno’s family dependency treatment court, participants are encouraged to call staff members or the judge at any time. Frequent hearings in a more relaxed court atmosphere and face-to-face meetings with team members encourage parent participation in the process. Although some parents initially are not very communicative, they eventually begin to feel less threatened and speak openly about their views if they are listened to and treated with respect.
Program Example: San Diego, California
As part of a pilot project, the San Diego County dependency court sometimes uses family group conferences, which recognize the value of allowing families to participate in the decisionmaking process when the well-being of children is concerned. The conference includes parents, members of the extended family, and individuals who the family considers supportive or able to provide resources (e.g., neighbors, clergy, or tribal elders). The goal is to jointly develop an action plan in the best interest of the child. This approach actively engages the family and capitalizes on family strengths, allowing for an expression of culturally appropriate processes and solutions.
Families may have varying needs and interests depending on how the court defines its target population and, in particular, whether the court serves families struggling with more than substance abuse. The focus group broadly characterized the FDTC target population as substance abusing parents who are at risk of losing their children. When asked to consider the possibility of establishing more specific criteria, the focus group first examined the applicability of the dependency treatment court model to persons with problems other than alcohol or drug abuse and arrested maturity. The possibility of serving individuals with co-occurring disorders or those who are mentally impaired raised questions about the court’s capacity to serve a broad population. The group agreed that the FDTC model probably could be applied to persons with special needs. The participants noted, however, that individual courts may want to explore the appropriateness of extending services to specific groups. Among the numerous factors to consider when making such a decision are the availability of resources and local services and the court’s experience level.
With the exception of the Jackson County court, the courts participating in the focus group place no restrictions on cases in terms of gender or age. Nevertheless, they agreed that the parents they are most likely to see are females who are raising children alone (or with minimal support from the children’s father or father figures). The typical parent’s emotional and psychological maturation is likely to be arrested, and there is a good chance he or she will lack the skills to hold a steady job. The parent is also likely to need parenting training and may have mental or physical health issues. It is quite possible that the parent grew up in a dysfunctional family environment, is the product of multigenerational abuse and neglect, and is currently a victim of domestic violence.
35 Chapter 6 Permanency and Safety for Children: Implications of the Adoption and Safe Families Act of 1997
Historically, child welfare workers and the courts have struggled to provide substance abuse treatment that enables parents to retain or resume child custody without jeopardizing the safety of their children. Cases have often lingered in the courts for years, with no permanent resolution, as the parents cycled in and out of treatment. Their children were left in foster care for months or even years—a condition often called foster care drift. Since the 1997 passage of the Adoption and Safe Families Act (ASFA), a renewed emphasis on establishing permanency for children within federally mandated timeframes has accelerated the need to find effective responses to substance abuse and child maltreatment within families. The passage of ASFA is forcing courts and related services to take innovative approaches to helping substance abusing parents stabilize their lives and maintain their families.
Although ASFA may present challenges to FDTCs, its intent—to prevent foster care drift—is in line with the goals and operation of FDTC programs. Family dependency treatment courts, with their early and intensive delivery of services, have great potential to help meet ASFA goals. The common characteristics of the FDTC—immediately available services, collaboration among stakeholders, and frequent court reviews—are essential to the successful implementation of ASFA. The accelerated timeframes; the accountability by the parent, service providers, and the court; and the reduced duplication of services that are characteristic of FDTCs all further the goal of safely returning children to their families or finding permanent placements for children who cannot return home.
This chapter discusses the implications of ASFA for family dependency treatment courts.
A Summary of the Adoption and Safe Families Act of 1997
In 1997, President Clinton signed into law the Adoption and Safe Families Act2 (Public Law 105-89). ASFA shortens the time children spend in foster care and specifies permanency options that lead to permanency, safety, and well-being for children. It calls on the nation’s courts and social service agencies to make the health and safety of children the paramount concern in placement and permanency decisions.
Congress’ intent in passing ASFA was to prevent foster care drift by moving children out of foster care and into safe and permanent placements as quickly as possible. ASFA places stringent requirements on the courts and the child welfare systems, holding them accountable for both the protection and permanent placement of children and for assistance with families— especially those in which substance abuse and addiction exist.
36 For the first time legislation, through ASFA, clearly states that the safety and welfare of children is paramount. Family dependency treatment courts adhere to this principle and are well positioned to work within the constraints of ASFA to provide parents with the tools they need to become nurturing, responsible adults who are ready to reunite with their children and able to provide them with a safe home environment.
Reasonable Efforts
ASFA mandates that child welfare agencies make “reasonable efforts” to preserve or reunite families. Specifically, the agencies must make reasonable efforts to:
• Prevent the initial removal of a child from his or her home (this applies only when keeping the family together does not endanger the health and safety of the child).
• Make it possible for a child who has been taken from the home to reunite with his or her parents (such efforts may occur during only the 12 months from the date the child entered foster care unless compelling reasons exist to extend the limit).
If reuniting a child with his or her parents is no longer the goal, the child welfare agency must place the child in a permanent, safe, and nurturing home.
When No Reasonable Efforts Are Required
To prevent children from languishing in the foster care system for extended periods of time, ASFA includes exceptions to the reasonable efforts requirement (National Council of Juvenile and Family Court Judges, 1998). The act acknowledges certain circumstances in which no efforts to preserve or reunite a family could be deemed reasonable. Specifically, reasonable efforts to preserve or reunite the family are not needed when any of the following circumstances exist:
• A child has been subjected to “aggravated circumstances” as defined by state law (e.g., abandonment, torture, chronic abuse, or sexual abuse).
• A parent has aided or abetted, attempted, conspired, solicited, or committed the murder or voluntary manslaughter of another of his or her children.
• A parent has committed a felony assault resulting in serious bodily injury to the child or to another of his or her children.
• A parent’s rights to another child have been involuntarily terminated.
Permanency Hearings
ASFA requires that a permanency hearing to determine a child’s permanent placement be held 12 months after a child enters foster care (starting from the date of adjudication or 60 days from the child’s removal from the home, whichever is earlier) or within 30 days of a determination that no reasonable efforts are required.3 At most, this leaves 14 months for a parent to succeed
37 under an established case plan before a permanency plan must be determined. (For an outline of the timelines required by ASFA, see appendix B.)
The permanency hearing involves significantly more than a review or an extension of placement. The hearing must determine the permanency plan for the child. Under federal regulations, the court must determine whether and when the child will be:
• Returned to the parent. • Placed for adoption, with the agency filing a termination of parental rights (TPR) petition. • Placed permanently with a fit and willing relative. • Referred for legal guardianship. • Placed in another planned permanent living arrangement (this final option is to be taken only in cases in which the agency has documented a compelling reason that none of the first four options would be in the child’s best interest).
Termination of Parental Rights Requirement
ASFA requires that a child protection agency file or join a TPR petition when a child under its protection has been in foster care for 15 of the past 22 months; the court determines that the child has been abandoned; or the court, following ASFA guidelines, determines that no reasonable efforts to preserve or reunite the family are required. There are three exceptions to the TPR requirements:
• The child is being cared for by a relative. • The agency has documented compelling reasons that TPR would not be in the best interest of the child. • The agency has not provided necessary services in a period consistent with the case plan (in cases where reasonable efforts are required).
The Reasonable Efforts Provision: Implications for the FDTC
At various points in the court proceedings, the judge must decide whether the agency has in fact made reasonable efforts—in light of a child’s current and future health and safety needs—to prevent removal, provide adequate services to reunite the family, or to diligently locate and secure an alternate permanent placement for the child. According to the National Council of Juvenile and Family Court Judges et al. (1987), reasonable efforts may consist of providing direct services, financial or in-kind benefits, or counseling assistance.
The FDTC model, with frequent and regularly scheduled hearings, is well positioned to ensure these efforts are made and to provide the judge with frequent opportunities to make a determination. Yet, making this determination is no small challenge. According to a 1999 analysis of data on child abuse and neglect—which included a survey of 916 professionals in the field and numerous indepth interviews with those on the front lines of child welfare—
38
Determining whether “reasonable efforts” have been exerted is practically and emotionally very difficult. Parents almost always oppose efforts to terminate rights to their children. Child welfare officials, many of them trained in social work and focused on “helping families,” are generally reluctant to recommend breaking up families. With an uncoordinated and often inconsistent delivery of services from various agencies and providers to assist families, family court judges often find defining “reasonable efforts” an elusive goal, especially since substance abuse is a factor in most cases and most child welfare workers and juvenile dependency court judges have little or no understanding of the nature of substance abuse or addiction, or the process of treatment and recovery (National Center on Addiction and Substance Abuse, 1999).
The challenge of defining “reasonable efforts” is potentially diminished in the FDTC due to the coordinated service delivery plan and a team approach to case management.
When No Reasonable Efforts Are Required: Implications for the FDTC
It is the court’s responsibility to inquire at each hearing whether any of the reasonable effort conditions outlined in ASFA apply. If so, and the judge agrees that no reasonable efforts are required, the court must hold a permanency hearing within 30 days. The agency must make reasonable efforts to place the child in accordance with the new permanency plan, including placing the child for adoption or with a legal guardian.
In the FDTC model a number of questions emerge: Is past history of failed drug treatment a circumstance in which no reasonable efforts should be required? Should a parent whose rights to a child previously were involuntarily terminated as a result of an inability to achieve sobriety while in treatment—which was inadequate or inconsistent—be prevented from participating in the FDTC’s program?
Anecdotal evidence from existing FDTCs suggests that even parents who might otherwise be considered a poor risk are able to succeed in a program of early and intensive treatment, and can reunite with their children. However, ASFA mandates that the child’s health and safety always be considered paramount. These and other questions will be answered as the research on successful graduates informs the field about identifying appropriate FDTC parents.
Permanency Hearings: Implications for FDTCs
For parents battling substance abuse—as well as the courts and substance abuse treatment providers—the 12-month timeframe for the permanency hearing has important implications. Even parents who are committed to achieving sobriety often require more than 12 months in substance abuse treatment before making significant progress, and one or more relapses during treatment are common. Responding to concerns from the field, the U.S. Department of Health and Human Services (HHS) entered the following commentary into the federal regulations:
39
“[P]arents dealing with substance abuse issues may require more than 12 months to resolve those issues. However, a parent must be complying with the established case plan, making significant measurable progress toward achieving the goals established in the case plan, and diligently working toward reunification in order to maintain the goal of a permanency plan at the permanency hearing. Moreover, the state and court must expect reunification to occur within a timeframe that is consistent with the child’s developmental needs.”4
For an FDTC parent or participant, reunification may continue to be the goal of the permanency plan if the parent meets these HHS conditions. However, the child’s safety must remain paramount. Although drug treatment services may be required for more than 12 months, this need should not be used to justify extending reunification efforts. Rather, reunification should be safely accomplished within the 12 months, with drug treatment continuing after reunification.
It is also essential that agencies promptly provide substance abuse treatment services. Historically, treatment service providers have lacked sufficient capacity to help parents who seek it—but the short timeframe imposed by ASFA increases the need for court systems to ensure close judicial supervision of, and coordination and accountability among, service providers. FDTCs are model programs that incorporate these vital components for meeting ASFA’s mandates.
Termination of Parental Rights Requirement: Implications for the FDTC
A substance abusing parent who complies with and makes substantial progress toward the goals in his or her case plan, and who diligently works toward reunification, may fall under the “compelling reasons” exception to ASFA’s TPR requirements. If the agency believes this is the case, the caseworker should document the specific reasons that make the parent’s progress a compelling reason not to file a TPR petition.
Because FDTCs are designed to provide early and intensive services, the third exception—when the agency has not provided necessary services in a period consistent with the case plan (in cases where reasonable efforts are required)—should not apply to alcohol and drug treatment services.
40 Chapter 7 Recommendations of the Focus Group
Family dependency treatment courts remain a new concept, but initial reports from the field indicate that the justice, child welfare, and substance abuse treatment systems are finding effective ways to collaborate. As a result, many allegedly abusive and neglectful parents who have substance abuse problems are receiving the services they need to make safe and stable homes for their children.
Although FDTCs currently exist in a limited number of jurisdictions, this new breed of family court has shown significant potential. To facilitate the efforts of court planners and to ensure that new court teams benefit from the experience of the first courts, the focus group proposes the following elements as a national strategy for validating and advancing the FDTC movement:
• Set minimum standards for family dependency treatment courts by which they can be defined and judged. As the field gains experience and research findings become available, these standards should be codified to guide the development and refinement of FDTCs.
• Develop gender-specific treatment and longer treatment programs. The lack of treatment programs that are longer and specifically designed for women is a serious concern in a court setting in which most parents are women.
• Develop effective aftercare programs that will keep graduates on their recovery and growth paths. Program graduates need a transitional link from the courts to the community that will provide the continued support and treatment they need. Aftercare should be available following graduation and, ideally, should be supplemented with a mentoring program or alumni association for long-term support, recovery, and ongoing healthy child development.
• Secure ongoing support from policymakers, community leaders, and the public. Support is necessary at every level of government, from the local community to state and federal representatives. Education and awareness among the general public are also needed so communities can appreciate FDTC efforts to promote child safety and parents’ recovery from substance abuse. Media attention can play a significant role in this process.
• Foster a clear understanding of the purpose of the family drug treatment court and the roles of the FDTC team among team members and other court and agency personnel. This is especially important for court personnel, for it is only through understanding that they will support the FDTC movement.
• Provide interdisciplinary cross training for FDTC team members on a local level. To sustain and improve on the efforts of existing FDTCs, the cross training of practitioners must be widely implemented. Sharing knowledge and skills across systems is necessary not only for optimizing the day-to-day operations of the court but for
41 establishing trusting relationships. Training must be ongoing, with representatives of FDTC organizations continually building their understanding of the team’s components and the strength that is possible through collaboration.
• Realign resources for service delivery, education, and outreach. Collaboration is an essential component of effective FDTC programs. Agencies and organizations must coordinate their efforts to frontload services, maximize resources, and build program capacity and sustainability.
• Identify funding sources and means to raise funds without breaching ethical standards. In each jurisdiction, it will be necessary to investigate the financial resources available through local, state, and federal avenues.
• Identify venues for education and training, and use them to increase understanding among stakeholders, legislators, the judiciary, the bar, and the public of the FDTC mission, goals, and process. A public information campaign is needed to educate the public and stakeholders about the promise and vision of FDTCs. Current leaders in the field need to use national and state conferences, forums, newsletters, and publications to mobilize decisionmakers and communities.
• Form collaborations of national organizations around dependency issues. Such organizations include, but are not limited to, the National Association of Drug Court Professionals, the National Drug Court Institute, the American Bar Association, the National Council of Juvenile and Family Court Judges, the Child Welfare League of America, and the National Association of the State Alcohol and Drug Abuse Directors.
• Establish measurements and basic data elements to evaluate FDTCs. The research community needs to establish the effectiveness of FDTCs. Programs need to incorporate evaluation components from the outset, develop uniform data elements, and demonstrate effective outcomes. The complexity of the FDTC approach makes it difficult to determine the type of data that should be measured. As evaluation procedures and models are developed, the field must collaborate effectively to share approaches to research and evaluation.
• Expand substance abuse treatment capacity and allocate resources for early intervention and treatment. Each community needs to develop a full continuum of resources. These services might include residential care, outpatient services, day treatment, individual and group counseling, and education.
• Recognize the distinctions between civil and criminal FDTCs in establishing program plans. Each program should be aligned with the legal and statutory requirements for its jurisdiction. Procedures and processes must account for the limits and authority of the court.
42 • Break down barriers. When barriers to collaboration exist between the court system, the child welfare system, and the substance abuse treatment community, they can prevent effective service delivery to families. Although federal agencies recognize and address these barriers and provide funding for some initiatives that attempt to break down barriers, much of the work necessary to change established systems must be done on state and local levels. New roles must be taken on at all levels—by social workers, treatment counselors, agency administrators, political leaders, and judges. Although the challenges are substantial, the potential rewards are even greater.
43 Chapter 8 Current Initiatives
Training for Family Dependency Treatment Courts
Training is critical to the implementation of an FDTC. However, because the FDTC differs significantly from the adult criminal and juvenile delinquency drug court models, a new approach to training is needed.
Responding to this need, in 2001 the Drug Court Planning Initiative (DCPI) began to offer training for jurisdictions planning a family dependency treatment court. During the first year, 42 jurisdictions participated in a two-part training. They first visited at least two host family dependency treatment courts and then attended a 4-day conference workshop. The workshop addressed the unique characteristics of FDTCs; provided substantive, topic-specific information in a practitioner-focused manner; and guided participants through the development of an implementation plan.
By 2002, the DCPI had refined and expanded the initial training conference into a series of three programs: introductory training, skills-based training, and operations training. Each program builds on the preceding program in the series. Together the programs lead participants through the process of designing and planning a family dependency treatment court, paying particular attention to implementation and institutionalization. A total of 68 jurisdictions participated in the training program in its first 2 years.
To ensure the planning teams that attend training represent the critical disciplines involved in FDTCs, each participating team is required to include a:
• Judicial officer.
• Child protective service or welfare service representative.
• Substance abuse treatment provider.
• Drug court or planning coordinator.
• Parent attorney.
• Agency attorney.
• Child attorney, guardian ad litem, or child representative.
• Evaluator.
• Management information systems specialist.
44 The DCPI training program is interactive, and it provides opportunities for teams to discuss, analyze, and plan for an FDTC. Specifically, jurisdictions are encouraged to examine issues that will affect the design of their FDTC, identify how the key leaders will address those issues, and work as a team to ensure the integrity and efficiency of the planning process.
The following description is excerpted from the training program series announcement:
Introductory Program
Purpose
To identify leadership roles in the planning process, to provide a foundation of information about how to apply the drug court concept within a dependency court practice, and to assist participants as they begin to plan for an FDTC.
Goal
To introduce the drug court concept and build common knowledge of its application in a dependency court setting, and to further develop the leadership skills essential to effectively implement an FDTC plan, particularly the skills of the judicial officer, child welfare representative, and coordinator.
Characteristics
• First in the series. • Three-day training for judicial officer, child welfare representative, and coordinator. • Observations offered by the host FDTC based on its experience (both the court staffing and courtroom). • Substantive topics include: o Implementation of ASFA. o Implementation of the National Council of Juvenile and Family Court Judges’ Resource Guidelines (1995) and Adoption and Permanency Guidelines (2002). o Family dependency treatment court characteristics. o Sustainability and community resources. o Responsibility to children and the evolution and promise of FDTCs. o Judicial and team leadership responsibilities.
45 Skills-Based Program
Purpose
To educate the planning team about issues, practices, and processes unique to FDTCs; to assist team members from each discipline as they examine the impact of the FDTC on their roles and responsibilities.
Goal
To begin drafting an FDTC policy-and-procedures manual by applying the knowledge and insight acquired as a result of the presentations; to determine how team members will collaborate to plan the FDTC.
Characteristics
• Second in the series. • Four-day training for entire planning team. • Observations offered by the host FDTC based on its experience (both the court staffing and courtroom). • Substantive topics include: o ASFA. o Indian Child Welfare Act. o Cultural competency. o Team building. o Intergenerational issues in substance use, abuse, and dependence. o Development of an FDTC mission statement. o Basics of substance abuse and dependence. o Management of information. o Targeting and eligibility. o Screening and assessment. o Management information systems. o Evaluation.
Operations Program
Purpose
To create the framework and policy for the FDTC, defining specific roles within the team and the jurisdiction.
46 Goal
To define treatment services and continuing care models, develop a program structure, identify sanctions and incentives, examine community resources, formulate an action plan, and finalize a policy and procedure manual.
Characteristics
• Third and final program in the series. • Three-day training for entire planning team. • Substantive topics include: o Assessment and treatment services. o Definition of your treatment services and continuing care models. o Case management, process and structure. o Management of participant behavior through incentives and sanctions. o Quality assurance and sustainability. o Ethics and confidentiality. o Ensuring team consensus. o Intergenerational issues related to substance use, abuse, and dependence.
Family Dependency Treatment Court National Cross-Site Evaluation Project
A significant project sponsored by the Center for Substance Abuse Treatment is now underway. This evaluation comprises five FDTCs. It examines whether the revised procedures, intense supervision, and early treatment interventions are instrumental in achieving the courts’ desired outcomes.
Funding for FYs 2002 and 2003
Funding streams and grants have changed since the focus group meeting in 1999. As noted in program sustainability, FDTCs are not limited to the actual dollars raised within the community. Program support can also come through nonmonetary resources and the reallocation of resources within communities. The following items identify potential funding opportunities for FDTCs:
• Fiscal Year (FY) 2002 appropriations for the Substance Abuse Prevention and Treatment Block Grant increased by $60 million from the FY 2001 funding level. It was estimated that FY 2003 appropriations would again be increased over FY 2002. This block grant to states provides funds for substance abuse prevention and treatment services.
• When treatment capacity is insufficient for a particular population (such as women and children), state and local agencies can apply for discretionary funds from SAMHSA’s Targeted Capacity Expansion Program.
• SAMHSA’s drug treatment court grant in FY 2002 provided more than $10 million in funding for 28 community drug treatment courts to provide substance abuse treatment for
47 juveniles, parents charged with abuse and neglect of their minor children, and substance abusing adults charged with criminal offenses. These grants will expand these courts— which provide targeted treatment services to break the cycle of child abuse, criminal behavior, alcohol or drug abuse, and incarceration—by funding alcohol and drug treatment and additional services that support substance abuse treatment. The grants, which are part of the SAMHSA drug courts initiative, will allow SAMHSA to support the goals of the Adoption and Safe Families Act. ASFA sets strict timelines for courts that have jurisdiction over parents who have neglected or abused their children.
• A number of states have expanded the substance abuse treatment services available through Medicaid in recent years. States may fund substance abuse treatment in many forms through the mandatory benefits required by the Health Care Financing Administration and may wish to consider this as an option for expanding treatment capacity. Many parents involved in the child welfare system are already eligible for Medicaid.
• Some substance abuse services can be paid for under Temporary Assistance for Needy Families (TANF) and welfare-to-work programs. Many families in the child welfare system that also have substance abuse problems receive welfare benefits. If parents’ substance abuse is interfering with their ability to care for their children, it may also be interfering with their ability to work. States and counties can incorporate substance abuse treatment services as part of their parents’ employment plans. Under these circumstances, TANF and welfare-to-work funds could be used for nonmedical aspects of substance abuse treatment if the treatment is not otherwise available. 4
• The Administration for Children and Families (ACF) is the lead HHS agency responsible for programs that promote the economic and social well-being of families, children, individuals, and communities. The FY 2002 budget requested $44.4 billion, a net increase of $1.2 billion, or 2.9 percent, from the FY 2001 funding level. Of these funds, $12.6 billion was allocated for discretionary programs, and $31.8 billion was earmarked for entitlements. The programs covered with this money include the Court Improvement Program (a grant program to help state courts improve how they handle foster care and adoption proceedings), child abuse and neglect programs (grants for states to improve and increase prevention and treatment activities), Community Service Block Grants (a program that provides states, territories, and Indian tribes with a flexible source of funding to help reduce poverty and address employment, education, housing assistance, energy, and health services), individual development accounts (a new program that empowers low-income individuals to save for a home), social services research, developmental disabilities, entitlement programs (TANF), childcare, and the Low- Income Home Energy Assistance Program.
48 • Title XX of the Social Security Act, also referred to as the Social Services Block Grant, is an entitlement program with funds capped at $2.8 billion. Block grant funds are given to states to help them achieve a wide range of social policy goals. Funds are allocated on the basis of population.
These resources may help FDTCs expand treatment capacity at the state and local levels. At the same time, FDTC programs can educate state and local leaders about the value of FDTCs and urge decisionmakers to expand resources that address the needs of children and parents involved in the child welfare system.
49 Appendix A: Focus Group Participant FDTC Program Descriptions
Family Treatment Court, Suffolk County, New York
In Suffolk County, New York, the number of child abuse and neglect cases continues to escalate. Parental substance abuse is believed to contribute to the majority of cases, placing children at substantial risk for out-of-home care. Despite the prevalence of cases involving substance abuse, neither the child welfare system nor the dependency system has been able to effectively meet the multifaceted needs of chemically dependent parents and their children. This has resulted in the fragmentation of services and poor coordination among service delivery systems. The Honorable Nicolette M. Pach, a family court judge in Suffolk County, responded to this need by researching the connection between substance abuse and child maltreatment. She assembled key stakeholders to further explore the problem and formulate a plan to address the needs of children and families.
Implementation of the Family Treatment Court
With the support of the Office of Court Administration and the Suffolk County District Administrative Judge, a steering committee composed of key court personnel, county leaders, and representatives from numerous county and community-based agencies was developed to explore resources, funding sources, policy concerns, and implementation issues. After a yearlong planning period, the Suffolk County Family Treatment Court (FTC) became operational on December 10, 1997.
The multidisciplinary, interagency effort integrates chemical dependency and child welfare services for alcohol- or drug-addicted parents and their children. The overall purpose of the program is to ensure the safety and well-being of children, to facilitate reunification efforts, and to expedite permanency planning. The program uses a comprehensive and integrated case management approach to meet the needs of chemically dependent parents and their children, including the developmental and health care needs of children. The program was the state’s first family drug court and initially relied on county and state funding, as well as in-kind contributions from participating agencies. The court later received a grant from the State Division of Criminal Justice Services and an additional grant from the Robert Wood Johnson Foundation.
Eligibility
FTC identifies substance abusing parents who have neglected their children by screening all of the original neglect petitions filed by the Department of Social Services (DSS) through local child protective services agencies. Parents who are alleged to have neglected or abused their children, who abuse alcohol or drugs, and who meet the established criteria will have their cases heard before the designated treatment court judge. Eligible parents are notified of the program and its requirements during their initial court appearance and are offered the opportunity to meet with staff to further discuss the program. Parents who are willing to admit neglect due to their substance abuse and who voluntarily opt to participate in the program sign an agreement and are scheduled to meet with members of the court-based case management team for an alcohol and drug family assessment.
50 Court Procedures and Operations
FTC emphasizes early intervention through the immediate assessment and referral to appropriate treatment and ancillary services of substance abusing parents who are charged with child abuse or neglect. Within 2 to 3 weeks of their initial court appearance, eligible parents are assessed and referred to the appropriate treatment, which includes an intake appointment with a treatment provider. This provider addresses the parent’s specific needs, including transportation and daycare services. Approximately 6 weeks following the parent’s initial court appearance, a dispositional order based on the service plan is entered. This order details the specific services designed to address the needs of the family. The goal of the court is to develop a comprehensive service plan that meets the needs of both the parents and the children.
Intensive case monitoring and frequent status reviews before the judge keep the court apprised of safety issues pertaining to the children, the parents’ progress in treatment, and progress toward permanency planning goals. This monitoring, which continues throughout the duration of the court order, enables the court to make informed decisions regarding placement issues.
FTC places increased emphasis on accountability. Parents are rewarded for progress in treatment and for meeting the requirements of the drug court. Conversely, they are sanctioned for noncompliance or failing to meet the needs of their children. Onsite alcohol and drug testing provides an effective measure of abstinence. Positive drug tests result in the reevaluation of treatment levels and other therapeutic interventions, as well as increased monitoring by the court. Willful contempt of court orders may result in up to 6 months’ incarceration. Progress is acknowledged through the three phases of the program, each of which addresses specific recovery and child welfare issues. Graduation is achieved after a minimum of 1 year of participation in the program, including 6 consecutive months of sobriety and a court-approved permanency plan. Aftercare services include ongoing supervision by child protective services.
Case Management, Treatment, and Related Services
Through its team approach to case management, FTC integrates chemical dependency and child welfare services, ensuring the delivery of coordinated services for the entire family. Court-based case management services enhance the efforts of DSS, and frequent case conferencing ensures that critical information is exchanged among service delivery providers. The development of a comprehensive plan that addresses the needs of the entire family is one of the foundations of the family treatment court. The strong assessment components leading to the development of this plan are also critical to ensuring that permanency planning efforts begin early in the process.
The enhanced assessment components of FTC are also integrated with the risk assessment conducted by DSS. This results in a more comprehensive and coordinated plan and a more inclusive court order. For example, in addition to placement and visitation issues, service plans frequently include services to address alcohol and drug issues, domestic violence, the mental health issues of parents, and the developmental and health care needs of children. Intensive monitoring of the service plan is key to the family treatment court. The team also serves as a resource for linkages to public assistance, housing, transportation, and other ancillary services.
51 As of late 2000, FTC was held 3 half-days per week before one judge. There are approximately 46–60 active cases at any time.
Preliminary Findings
FTC recently began evaluation efforts; however, some benefits of the program can already be seen. Parents have been able to access appropriate treatment in an expedited manner. Intensive monitoring is identifying family needs and problems early so that assistance can be provided and the safety of children can be ensured. The court receives comprehensive status reports, enabling informed decisions concerning the placement of children. Also as a result of integrating services, new relationships are developing among treatment providers, child welfare professionals, and the court.
Contact Information
Christine L. Olsen, C.S.W. Project Director Telephone: 631–853–4482 Fax: 631–853–7616 E-mail: [email protected]
Dependency Court Recovery Project, San Diego, California
San Diego County receives approximately 90,000 reports of suspected child abuse or neglect each year. Of these cases, approximately 2,400 come under the jurisdiction of the dependency court. In such cases, the court may remove supervisory authority or custody of the child from the family and transfer custody to the county child protection agency (there are approximately 9,000 children in the county’s dependency system). In San Diego County, the Superior Court Juvenile Division’s seven dependency courts and the Health and Human Services' Children’s Services Division handle the cases.
Before 1997, San Diego County’s dependency system had tremendous difficulty making timely permanent placement decisions for children. A review of the case files indicates that 80 percent of dependency cases involved alcohol or drug abuse by one or both parents. However, many parents in the court system were not receiving prompt and effective substance abuse treatment, which forced the dates for reunification plans and placement decisions to be extended. As a result, the county was not able to resolve cases within the state’s statutory guidelines. In 1994, case resolution averaged 34 months. Children spent significant time in foster care, often with three changes in placement, which led to further trauma and psychological problems among these children.
52 A Systems Approach
In response to this situation, the presiding judge of the juvenile court, the Honorable James R. Milliken, brought together a team of key stakeholders in the dependency system to collaboratively implement a series of rapid reforms designed to achieve either family reunification or the timely and permanent placement of children outside the home. Stakeholders included the San Diego County Board of Supervisors, judges, court and county administrators, attorneys, social workers, foster parents, substance abuse treatment providers, parents, and juveniles. A policy group was also established to provide a forum for the discussion and development of policies on how dependency cases should be handled from beginning to end.
The resulting Dependency Court Recovery Project emphasizes compliance with statutory timelines for decisionmaking in all dependency cases. Eight major court-reform measures address both the general court reforms and the specific alcohol and drug concerns. Directly addressing these concerns is a two-tiered system of court supervision and substance abuse treatment.
The First Tier: Dependency Court
Within the dependency court, each parent against whom an abuse or neglect petition is filed is subject to the requirements of the dependency court. If alcohol or drugs are an issue, the parent is also subject to the requirements of the Substance Abuse Recovery Management System (SARMS). Through SARMS, Mental Health Systems, Inc. (a nonprofit organization under contract with the county) provides case management services to help parents address their substance abuse problems and encourages sobriety. The SARMS recovery specialist conducts the substance abuse assessment, enrollment, alcohol and drug testing, and progress monitoring and reporting. He or she also works with the participant to prepare a Recovery Services Plan that identifies the required treatment. Dependency parents attend counseling, therapy, education sessions, and recovery support groups through community-based treatment programs and submit to frequent alcohol and drug tests. SARMS reports to the court and Children’s Services Division on a twice-monthly basis regarding parents’ progress in treatment and the results of the alcohol and drug tests. In addition to the normal dependency review hearing schedule, 30- and 60-day SARMS review hearings are required, and the parent is encouraged to seek treatment before the 30-day hearing.
A social worker from the Children’s Services Division remains the principal case manager and is responsible for the overall dependency case management. The addition of the SARMS recovery specialist provides case management for the parents’ substance abuse issue only.
SARMS recovery specialists initially work actively with participants toward compliance with their recovery services plans, which are an automatic condition of the court order. Violation of the order results in sanctions of increasing severity: first, a reprimand from the judge; second, jail time and/or a fine; third, jail time and/or a fine or referral to the dependency drug court.
53 The Second Tier: Dependency Drug Court
The dependency drug court, a major component of the Recovery Project, is designed for dependency court parents who fail to meet the SARMS recovery services plan treatment goals. The dependency drug court operates an intensified three-phase program of treatment and heightened supervision, with each phase lasting 90 days. In Phase 1, a court appearance is required once a week. In Phase 2, a court appearance is required every 2 weeks. In Phase 3, a court appearance is required once a month. The parent is expected to cooperate fully with the conditions of the recovery services plan and to submit to random alcohol and drug tests in conjunction with dependency drug court appearances. If the parent is uncooperative and repeatedly fails to meet the recovery service plan goals, a permanency hearing to terminate parental rights may ensue.
Case Management, Treatment, and Related Services
SARMS is an extensive case management system that uses a broad range of treatment options to address the needs of parents in both tiers of the dependency court system. Through funding from the San Diego County Board of Supervisors and activities of the Health and Human Services Agency’s Alcohol and Drug Services, the county network of contract treatment providers has been expanded to serve the immediate needs of the dependency population. The recovery services plan developed by the SARMS recovery specialist may include counseling, therapy, education sessions, and attendance in support groups. In addition to traditional inpatient and outpatient services, programs that can house parents (usually mothers) with their children are sought. Such facilities provide a “SAFE (sober and friendly environment) house” for the care and well-being of the family as parents progress through the recovery process. When possible, necessary services, such as parent-skills training, employment, and mental health and medical treatment, are within walking distance. The expectation is that a continuum of services and early intervention will strengthen the family and result in increased chances for success. However, the best interest of the child always remains the paramount consideration, and dedicated foster parents are valued for their role in making the dependency system work when the child cannot safely stay with the parent.
Dependency courts sometimes use family group conferences to allow families to participate in the decisionmaking process concerning the protection and safety of their children. This process involves parents as well as members of the extended family. With the guidance of the Children’s Services Family Unit, meeting staff who are trained as family group conference facilitators, family members, and the participating support groups meet to formulate a plan for the child, which is then presented to the Health and Human Services Agency. This approach capitalizes on family strengths, allows for the expression of culturally appropriate solutions, and engages the whole family in accepting responsibility for the children.
As of late 2000, the dependency drug court was in session 3 days a week before one judge. Approximately 60 cases are active at a given time.
54 Preliminary Findings
The majority of clients are responding well to the program. Preliminary progress reports reflect an 81 percent compliance rate with the recovery services plan. More than 1,200 parents have received SARMS case management services.
Contact Information
The Honorable James R. Milliken Presiding Judge of the Juvenile Court Telephone: 858–694–4543
Andrea Murphy Superior Court Special Projects Manager Telephone: 619–515–8678
Caroline Rodlex Director of Juvenile Court Telephone: 858–694–4211
Family Drug Court, Jackson County (Kansas City), Missouri
The family drug court was established in the Sixteenth Judicial Circuit Court of Jackson County, Missouri, in 1998 to address an increasing number of problems associated with alcohol and drugs. The court’s goals are to stop parental substance abuse that threatens the safety and permanency of their children and to stop substance abuse by delinquent juveniles or their parents that places the juveniles at risk of further delinquent behavior. The overall mission of the court is “to provide judicially managed, community-based, close supervision and specialized treatment to parents and juveniles whose substance abuse places their children or themselves at risk of substantially increased intervention by the justice system.” The court was initially a participant in a pilot project under the auspices of CSAT and, in October 1998, received an implementation grant from the U.S. Department of Justice’s Drug Court Programs Office.
Eligibility
Eligibility is based on established written criteria, and eligible clients are identified immediately after charges are filed. Clients are promptly advised about family drug court requirements and the merits of participating. Eligible individuals are screened both for substance abuse problems and their suitability for treatment by trained professionals, must appear promptly before the drug court judiciary, and are enrolled in a treatment program. Jackson County has a combined court system that facilitates case processing in cases when both abuse or neglect issues and juvenile delinquency exist. However, the focus of this description is on cases related to child dependency or child endangerment, including:
55 • Child dependency cases, defined as abuse or neglect civil cases, including any case filed pursuant to child abuse or neglect statutes when parental substance abuse is the primary or underlying cause for the neglect or abuse of the child.
• Child endangerment or criminal cases (diversion), including criminally filed child endangerment cases in which the defendant or mother has had at least one drug-exposed child with a subsequent baby testing positive for any abused substance at the child’s birth, or a criminal defendant eligible for the adult drug court who also has a child who is the subject of a dependency proceeding in the family court.
Court Procedures and Operations
To address these civil and criminal child dependency cases, the family drug court uses a team approach, which includes the family drug court commissioner, the family drug court manager, the attorney for the juvenile officer, the defense attorney, the adult prosecutor, the guardian ad litem, treatment providers, social service providers, family members, and other interested parties. The court has also established relationships with private and public community-based organizations, public criminal justice agencies, law enforcement, and substance abuse treatment delivery systems that can provide linkages to education, housing, vocational rehabilitation, and other services. These relationships have expanded the continuum of services available to clients and helped educate the community about family drug court concepts.
In this approach, the roles of the child dependency/juvenile justice practitioners and substance abuse treatment providers are very different from those in a traditional court. The judge is the central figure on the team, focusing on sobriety, lawful behavior, accountability, and engaging clients in treatment. The court’s focus remains on the best interest of the child. Treatment providers keep the court informed of each client’s progress so that incentives and sanctions can be appropriately applied. The court operates a coordinated, systemic approach to the substance abuser through comprehensive planning that includes a method for data collection and program evaluation.
Case Management, Treatment, and Related Services
The period immediately after charges are filed is a critical window of opportunity for intervention, and the value of substance abuse treatment is emphasized during this time. It is critical that the referral to the family drug court be immediately followed by a court appearance for the intervention to be effective. Treatment is unique to the individual, taking into account his or her biopsychosocial and cultural needs. The model uses a holistic approach to the client and family treatment plan and incorporates medical and mental health needs, financial issues, housing, vocational needs, and family and legal issues. Comprehensive services include individual and group counseling, relapse prevention, self-help groups, preventive and primary medical care, general health and nutrition education, parenting skill training, domestic violence education, and treatment for the long-term effects of childhood physical and sexual abuse. Case management ensures an uninterrupted continuum of care and monitoring of client progress.
56 Abstinence is monitored by frequent urinalysis. Sanctions are imposed for continued substance abuse, and the severity of sanctions increases for continued noncompliance. The overriding focus is always the best interest of the child.
The family drug court is in session three afternoons a week and has approximately 60 active cases at any given time.
North Star Recovery Services
North Star Recovery Services provides a range of program and treatment services for women, men, and children. It is the family drug court’s partner for the provision of services for mothers or babies who test positive for drugs. North Star offers residential, day outpatient, intensive outpatient, and continuing care treatment services. A multidisciplinary team includes counselors, community support workers, a family therapist, a child therapist, nurses, psychiatrists, child development teachers, and vocational counselors. A great emphasis is placed on empowering women as they rebuild their self-esteem and develop healthy relationships. Through the program’s child development center, mothers can develop the skills to foster healthy, nurturing relationships with their children.
Contact Information
The Honorable Molly M. Merrigan Commissioner, Family Drug Court Telephone: 816–435–8033
Pamela D. Johnson Family Court Management Analyst Telephone: 816–435–4775
David Kierst, Jr. Juvenile Officer/Family Court Administrator Telephone: 816–435–4850
Penny Howell Program Manager Telephone: 816–435–4757
North Star Recovery Services General Information Telephone: 816–931–6500
57 Family Drug Court, Reno, Nevada
The family drug court in Reno, Nevada, began in 1995 in response to the rising number of child abuse and neglect cases involving parental substance abuse. Heavy caseloads prevented social service caseworkers from meeting with parents more than once a month, and because of a backlog in the judicial system, children languished for years in foster care. In addition, the same families often cycled repeatedly through criminal and family courts because of problems related to substance abuse. Judge Charles McGee of Washoe County, Nevada, became motivated to try a new approach to help children and parents with substance abuse problems.
In 1995, Judge McGee, who had 17 years of experience as a general jurisdiction, juvenile court, and family court judge, designed the first family drug court. He used information about criminal drug courts obtained from a colleague to develop the court’s approach and launched the program with a budget of $15,000. The court now operates with funds from participating agencies, the overall county court administration budget, and a grant from a private foundation; it has also secured funds from the county child welfare agency to pay for substance abuse treatment.
Eligibility
Families are eligible for the program if their children are placed at risk by their parents’ involvement in substance abuse. They may be identified by criminal activity on the part of a parent or because children are being removed from the home as the result of abuse or neglect. The respondents who appear before the family drug court judge are mostly women with addiction problems. Many are victims of domestic violence, have histories of physical and sexual abuse, and are often in destructive relationships with men. The families are normally referred by child protective agencies or drug treatment programs. However, this is a voluntary program, and families may elect not to participate or to discontinue participation and have their cases revert back to the traditional court docket.
Each parent must make a commitment to (1) refrain from alcohol and drug use, (2) meet with the judge twice a month for progress hearings, and (3) accept sanctions for failure to comply with any ordered obligations. In exchange, the program provides a minimum of 1 year of substance abuse treatment, increased social services, and a support system consisting of the judge, his staff, a case manager, the treatment provider, and a child welfare caseworker. On acceptance of these conditions, families enter into a yearlong program of intensive intervention with the goal of reuniting as a healthy, stable family unit.
Court Procedures and Operations
Parents must appear before the judge every other week for a hearing. Before this hearing, the judge confers with staff members involved in the case to discuss the parents’ progress and related issues. Staff members may include the treatment provider, child welfare caseworker, case manager, prosecutor, defense counsel, probation officer, and foster grandparents. All staff from each agency that has contact with the parents must attend the conference. At the hearing, success is reinforced through praise and encouragement, but parents are held strictly accountable for failed drug tests or missed treatment appointments. Failure to appear for a drug test or a positive
58 test usually results in 2 days in jail. Caseworkers make arrangements for the care of the child. For participants further along in the program who relapse, community service may be allowed, or jail time may be deferred to the weekend to prevent employment conflicts. Other parent participants in the court program may sit in the gallery during these hearings.
The Reno family drug court is a 12-month program, and the participant must be entirely sober and drug free for 3 consecutive months before graduation. The graduate may be required to attend 3 months of aftercare, which consists of attendance at monthly hearings and aftercare treatment. During this time, the graduate’s progress in recovery is monitored, and appropriate parenting of the children is ensured. The strength of the court is based on the fact that the judge, the court staff, the caseworkers, prosecutors, defense counsel, and the treatment professionals are personally involved with the families.
Case Management, Treatment, and Related Services
A comprehensive assessment is conducted immediately to identify family needs. Services provided include drug treatment, coping and life-skills development, parenting skills education, and integrated services case management. Participating agencies give their appraisal of the family and recommend a course of action. Each agency is asked to honor the goals of the others, work through turf issues, and identify gaps in service provision. Through this collaborative approach, an individualized plan with specific goals is developed. The judge in Reno hired a service coordinator, based in his court, to ensure that participants receive all necessary services.
Two treatment programs provide assessment and treatment. One program, an inpatient track called Step II, is designed for women only. Step II allows children to live with their mothers; it also provides drug testing for women twice a week. The other track, an intensive outpatient program called CHOICES, is designed for both men and women, and all the couples in family drug court participate in this track. The outpatient track monitors clients by conducting drug tests three times a week. A nonprofit group, Tru Vista, can also provide family group conferencing services. Court staff members monitor the capacity of each program and accept new participants in the drug court only if treatment openings are immediately available.
Family drug court is in session 1afternoon per week before a single judge. The program had approximately 60 participants as of late 2000.
Preliminary Findings
Although no formal evaluation has been done, 74 participants have graduated from the program since 1999. Screening for substance abuse has improved because of the social services caseworkers’ close involvement in the family drug court. Access to ancillary services has greatly improved because of the efforts of the service coordinator. Program staff members believe that the clear case plan and close monitoring of progress allow for informed decisions on the part of the judge concerning child custody and better quality of service for families.
59 Contact Information
Victoria (Tori) King Court Clerk Second Judicial District Court Department 2 One South Sierra Street P.O. Box 30083 Reno, NV 89520 Telephone: 775–328–3144
60 Appendix B. Adoption and Safe Families Act Timeline
▲If the review hearing is held by the court, it must be held at least once every six months. ○ The determination that reasonable efforts to finalize the plan be made is often made at the permanency hearing, although it can be made at another point in the proceedings as long as the 12 month deadline is met. † When calculating when to have the permanency hearing or the 15 of 22 months, use the earlier of the date of adjudication OR 60 days after the child is removed from the * Unless one of the following exceptions is documented: child is being cared for by a relative, agency has not provided services it has deemed necessary to rehabilitate the family, or a compelling reason exists. Source: This timeline was originally prepared by Mimi Laver and published in ABA Child Law Practice, Vol. 17(8), p. 119. It was updated and amended by the authors for this book. ©1998, American Bar Association. All rights reserved. Reprinted with permission from the ABA Center on Children and the Law, Washington, D.C. For more information about this publication or to receive a free sample issue, contact Lisa M. Waxler, Publications Coordinator, at 202–662– 1743; e-mail: [email protected].
61 Appendix C: Recommendations for Research and Evaluation
In its Review of Specialized Family Drug Courts: Key Issues in Handling Child Abuse and Neglect Cases, the Urban Institute (1999) made the following recommendations regarding the research and evaluation of family drug treatment courts:
Process evaluation. Studies need to document the policies and procedures developed by courts around the country. Issues that should be examined include confidentiality, staffing patterns, interagency collaboration, sanction and incentive practices, and advocates' concerns regarding civil rights of parents and children.
Service needs of parents and children. These address substance abuse treatment, legal issues, health, employment, housing, domestic violence, and other areas.
Outcomes for children. Short-term outcomes include the duration and number of foster care episodes and the final placement decision. Long-term outcomes for those placed with their parents include the percentage named in subsequent abuse or neglect petitions, and when parental rights are terminated, the percentage of children adopted.
Outcomes for parents. Short-term outcomes include graduation or failure to graduate from treatment, participation in aftercare following case termination, perceptions of fairness of the court process, effects of the process on treatment motivation and retention, and assessment of the relationship between FDTC services and reduction in problems faced by parents.
System impacts. For courts, these include the duration of cases, the number of hearings, the demands for resources, the net-widening effects of encouraging early intervention, the potential efficiencies of combining multiple petitions for multiple children in a family in a single case, and the potential for linking drug court cases with active cases in other courts. For other systems, these include the effect on demand for staff and services, requirements to change procedures, and barriers to participation based on agency mandates or funding.
Direct expenditures and in-kind contributions. These include those paid for by existing agency funds, insurance, special government programs, private funds, and funding received from agencies and community groups. This information is needed for a comparison with the costs of existing procedures for handling these cases.
62 Appendix D: Family Intervention Programs
Contact information for each of these programs can be found at www.strengtheningfamilies.org.
HOMEBUILDERS Program
The HOMEBUILDERS Program is one of the best documented family preservation programs in the country. It is designed for the most seriously troubled families referred by child service agencies. Populations served include newborns to teenagers. The program is designed to break the cycle of family dysfunction by preventing foster care, residential, and other out-of-home placements, and to strengthen the family. Program goals include improving family functioning, increasing social support, increasing parenting skills, improving school and job attendance and performance, improving household living conditions, establishing daily routines, improving adult and child self-esteem, helping clients become self-directed, and enhancing motivation for change while decreasing family violence.
The program includes 4 to 6 weeks of intensive in-home services to children and families. A practitioner provides counseling and other services, spending an average of 8 to 10 hours per week in direct contact with the family; the practitioner is on call 24 hours a day, 7 days a week for crisis intervention. Therapeutic processes used include skills building, behavioral intervention, motivational interviewing, relapse prevention, rational emotive therapy, and other cognitive strategies.
HOMEBUILDERS has been evaluated both formally and informally since it began in 1974, and results have shown repeated positive findings on a variety of measures focusing on placement prevention and on child and family functioning.
Strengthening Families Program
The Strengthening Families Program (SFP) is a family-skills training program designed to reduce risk factors for substance use and other problem behaviors in high-risk children of substance abusers, including behavioral, emotional, academic, and social problems. SFP builds family relationships and parenting skills and improves the children’s social and life skills. It is designed for families with children 6 to 10 years old and has been modified for African-American families, Asian and Pacific Islanders in Utah and Hawaii, rural families, Hispanic families, and early teenagers in the Midwest.
SFP participants attend 14 weekly meetings, each 2 hours long. SFP includes three separate courses: Parent Training, Children’s Skills Training, and Family Life Skills Training. Parents learn to increase desired behaviors in children by using attention and reinforcements, communication, substance use education, problem solving, limit setting, and maintenance. Children learn about communication, understanding feelings, social skills, problem solving, resisting peer pressure, and complying with parental rules. The meetings also include opportunities for questions and discussion about substance use. Families practice therapeutic child's play and conduct weekly family meetings to address issues, reinforce positive behaviors,
63 and plan activities together. SFP uses creative strategies—such as providing transportation, child care, and family meals—to retain families in treatment.
Positive outcomes have been found in a number of independent program evaluations. Parents reported significant decreases in drug use, depression, and use of corporal punishment, as well as increased parental efficacy. Children became less impulsive, improved their behavior at home, and exhibited fewer problem behaviors in general. Children also reported fewer intentions to use tobacco and alcohol.
Treatment Foster Care
Treatment Foster Care (TFC) is a parent training program that works with foster parents to provide 6-month placements for 12- to 18-year-old adolescents referred to the program because of chronic delinquency. The teenagers’ biological parents or guardians are involved intensively both during the placement period and a 12-month aftercare period. Youth are referred by the juvenile justice system.
The treatment goals for the referred youth’s parents are to increase their parenting skills, particularly the ability to supervise and use effective discipline strategies, to increase their level of involvement with their child, and to help them engage in prosocial activities in the community. Treatment goals for the referred youth are to reduce criminal behavior and substance use, improve school attendance and grades, reduce association with delinquent peers, and become better able to live successfully in a family setting.
After intensive preservice training, TFC parents are contacted daily to monitor their children’s progress and problems, and they attend a weekly meeting to receive supervision and support. TFC parents implement a daily behavior management program that is individualized for each TFC adolescent. Each day, youth participants have the opportunity to earn and lose points that translate into long- and short-term privileges. As they progress through the program, the level of supervision and control over their activities is reduced. Youth also participate in weekly, skills-focused individual therapy. The youth attend public schools, where their attendance and performance are tracked on a daily basis. Twenty-four-hour-a-day, 7-day-a-week on-call support is provided to TFC parents and parents or guardians during home visits and in aftercare.
The effectiveness of the TFC program has been demonstrated in several studies. TFC boys reported significantly fewer psychiatric symptoms, had better school adjustment, returned to their family homes after treatment more often, and rated their lives as being happier than boys in group care placements. This model is now being adapted for adolescent girls who are referred by the juvenile justice system but who have serious mental health problems.
64 Functional Family Therapy
Functional Family Therapy’s (FFT) primary goal is to improve family communication and supportiveness while decreasing the intense conflicts so often characteristic of troubled families. Other goals include helping family members identify what they desire from each other, identifying possible solutions to family problems, and developing powerful behavior change strategies.
The program is conducted by family therapists working with each individual family in a clinical setting, which is standard for most family therapy programs. More recent programs with multiproblem families involve in-home treatment. The model includes four phases: introduction/impression, motivation (therapy), behavior change, and generalization (more multisystem focused). Each phase includes assessment, specific techniques of intervention, and therapy goals. The intervention involves a strong cognitive/attributional component that is integrated into systemic skills training in family communication, parenting skills, and conflict management skills. The FFT model has been evaluated many times since its inception in 1971, and its effectiveness has been repeatedly demonstrated.
Effective Black Parenting
Effective Black Parenting (EBP) is a cognitive behavioral program created to meet the specific needs of African-American parents. It facilitates efforts to combat child abuse, substance abuse, juvenile delinquency, gang violence, learning disorders, behavior problems, and emotional disturbances. It seeks to foster effective family communication, a healthy sense of African-American identity, and healthy self-esteem. The program emphasizes the importance of extended family values and provides information on child growth and development. It is grounded in basic parenting strategies and offers information appropriate for all socioeconomic levels, but it is especially effective for parents of children 2 to 12 years old.
The program is taught in two formats. In one format, program participants attend 15 3-hour training sessions that emphasize role playing and home behavior projects. The second format is a 1-day seminar version for large groups of parents. Black educators and mental health professionals teach a series of basic child-management skills using African proverbs and African-American linguistic forms and emphasize African-American achievement and competence. In addition, the interactive groups address respectful and rulebreaking behaviors, traditional and modern discipline, black pride, black self-disparagement, coping with racism, African-origin family values, preventing drug use, and single parenting. Two companion parent training programs are also available: Confident Parenting, for the general parent population, and Los Niños Bien Educados, for Latino parents.
Evaluations of the program have shown a significant decrease in parental rejection, an increase in the quality of family relationships, and improved child behavior outcomes. Both formats have been well received in African-American communities nationwide, and 2,000 instructors have already been trained and are using the program in schools, community agencies, churches, mosques, and Urban League affiliates.
65
Nurturing Parenting
The Nurturing Parenting programs are family-centered programs designed to build nurturing skills as alternatives to abusive parenting and child-rearing attitudes and practices. The ultimate desired outcomes are to stop the generational cycle of child abuse by building nurturing parenting skills; reducing the rates of recidivism, juvenile delinquency, and alcohol abuse; and lowering the rate of teenage pregnancies.
Nurturing Parenting is based on a reparenting philosophy. Parents and children attend separate groups that meet concurrently, with cognitive and affective activities designed to build self-awareness, positive self-esteem, and empathy. The program teaches alternatives to shouting and hitting and enhances family communication and awareness of individual needs. It attempts to replace abusive behaviors with nurturing ones, promote healthy physical and emotional development, and teach appropriate role and developmental expectations.
Thirteen different programs address specific age groups (infants, preschool through middle school age, and teenagers), cultures (Hispanic, Southeast Asian, African-American), and needs (special learning needs, families in alcohol recovery). Programs can be implemented in group or home sites from 2 to 3 hours a week for 12 to 45 weeks. The program includes parenting skills, self-nurturing activities, home practice exercises, family nurturing time, and infant, toddler, and preschool activities. The program has been adapted for Hmong, Hispanic, and African-American families. The initial Nurturing Program for Parents and Children 4 to 12 Years has been field tested extensively, and significant positive increases were found in parenting attitudes and the personality characteristics in parents, children, and family interaction patterns.
Health Start Partnership and CARES Parenting Program
The Health Start Partnership and CARES Parenting Program are promising parenting programs that grew out of one agency’s prenatal and pediatric services unit. The overall goal is to foster secure mother-infant attachments by encouraging responsive parenting. This is accomplished through by helping new or expectant mothers understand child development, form realistic expectations, learn to respond to infant cues, gain perspective on their own childhood issues and roles as a parent, and find and learn to use social supports. It is rooted in attachment theory and includes three essential components: home visits, support and education groups, and medical care. Risk factors that indicate a need for project services include a personal history of maltreatment or out-of-home placement; conflicts, including abuse by a partner or spouse; negative feelings about the pregnancy; limited support; social isolation; economic stress; unmet personal needs; and chaotic family systems.
Women are enrolled in late pregnancy or as early in the postpartum period as possible. The partnership program is designed for a group of 8 to 12 women with infants born within a few months of each other. Clients meet every other week, with home visits on alternate weeks, for about 2 years. The CARES group is always open to new members. Enrolled children range in age from newborn to 5 years, and families graduate when the last drug-exposed child is enrolled
66 in kindergarten. CARES provides regular home visits and weekly support groups, with medical care and lunch provided onsite. Transportation is provided for all groups.
Evaluation data for this program indicate a decline in abuse and neglect rates. In addition, all children who remained with the project until its completion were fully immunized by 30 months of age or were up to date on immunizations when the project ended.
Multisystemic Therapy
Multisystemic Therapy’s (MST) primary goals are to reduce out-of-home placements and antisocial behavior in adolescents, and empower families to resolve future difficulties. MST is an intensive family-based treatment addressing the known determinants of serious antisocial behavior in adolescents and their families. On a highly individualized basis, treatment goals are developed in collaboration with the family, and family strengths are used as levers for therapeutic change. MST treats factors in the youth’s environment that contribute to behavior problems. Such factors might pertain to individual youth characteristics (e.g., poor problem-solving skills), family relations (e.g., inept discipline), peer relations (e.g., association with deviant peers), and school performance (e.g., academic difficulties). Specific MST interventions are based on the best empirically validated treatment approaches, such as cognitive behavior therapy and pragmatic family therapies.
Several programmatic features are crucial to the success of MST. First, the use of the family preservation model of service delivery (i.e., low caseloads, home-based services, time-limited duration of treatment) removes barriers to access to care and provides the high level of intensity needed to successfully treat both youth who present serious clinical problems and their multineed families. Second, the philosophy of MST holds service providers accountable for engaging the family in treatment and for removing barriers to successful outcomes. Such accountability clearly promotes retention in treatment and attainment of the treatment goals. Third, outcomes are evaluated continuously, and the overriding goal of supervision is to facilitate clinician attempts to attain favorable outcomes. Fourth, MST programs place great emphasis on maintaining treatment integrity so considerable resources are devoted to therapist training, ongoing clinical consultation, and service system consultation. Rigorous evaluation that demonstrates the program’s effectiveness is a hallmark of MST.
Brief Structural/Strategic Family Therapy
Brief Structural/Strategic Family Therapy (BSFT)5 evolved from a program involving Cuban-American families with youth who abused drugs and exhibited behavior problems. It is currently applied to families from other Hispanic-American groups and to African-American families. Therapy is tailored for and delivered to individual families, sometimes in their homes. A basic premise of BSFT is that families’ maladaptive ways of relating are an important factor in the development of problems such as substance abuse. Therapists seek to change these maladaptive interaction patterns by choreographing family interactions during therapy sessions and creating the opportunity for new, more functional interactions to emerge. Therapists are trained to assess and facilitate healthy family interactions based on the cultural norms of the
67 family being helped. Structural Ecosystems Therapy, a variation of BSFT, is currently being applied and tested in the families of HIV-positive African-American women, caregivers of patients with Alzheimer’s disease, and drug-abusing youth.
BSFT has been rigorously evaluated in a number of studies. The approaches have been found to be an effective means to improve family relationships, improve youth behavior, and reduce recidivism among youthful offenders.
Center for Development, Education, and Nutrition
The Center for Development, Education, and Nutrition (CEDEN) provides comprehensive services that promote and strengthen families in need of prenatal, early childhood, and parenting education. The agency’s programs seek to improve the outcomes of pregnancies among adolescents and at-risk women by providing information on reducing the incidence of premature and low-birthweight babies. The agency also provides services to prevent and reverse developmental delays, increase positive parenting behaviors, reduce injuries, and ensure timely immunizations. CEDEN serves primarily low socioeconomic families and parents with children 0 to 5 years old who have developmental delays or are at risk of becoming developmentally delayed.
CEDEN’s home-based programs accommodate family needs by working with children at childcare centers, relatives’ homes, shelters for homeless or battered women, and other community shelters. The frequency of home visits is based on the family’s needs and may range from weekly to monthly. Parent educators deliver a series of educational materials, including early childhood stimulation activities, age-appropriate activities, basic health and nutrition care, home safety, and a profamily curriculum focusing on child development, behavior, and skills building.
Program evaluations demonstrate CEDEN’s ability to improve the status of young children with developmental delays. Children participating in the program maintain up-to-date immunizations at a higher-than-average level for the community. Parents report satisfaction in learning and using alternative disciplinary methods; they also feel they understand their children better after participating in CEDEN’s programs. In addition, parenting classes and support groups help reduce the social isolation of mothers by facilitating friendships and boosting self-esteem.
Home-Based Behavioral Systems Family Therapy
Home-Based Behavioral Systems Family Therapy is based on the Functional Family Therapy model but targets families with lower educational levels and higher levels of pathology than the original model. Intermediate objectives include decreased family conflict and increased cohesion; improved family communication; improved parental monitoring, discipline, and support of appropriate child behavior; improved problem-solving abilities and parent-school communication; improved school attendance and grades; and improved child adjustment. Long-range objectives include reductions in the child’s involvement in the juvenile justice
68 system, self-reported delinquency, teen pregnancy, and special class placement, along with increased graduation rates and employment.
The program is delivered in five phases: introduction/credibility, assessment, therapy, education, and generalization/termination. In the program’s early phases, therapists are less directive and more supportive and empathic than in the later phases—when the family’s cooperation and lowered resistance allow for increased therapist directiveness.
Evaluations have indicated robust treatment effects that are not the result of chance.
69 Appendix E: Strengths, Challenges, Opportunities, and Threats
In a series of exercises designed to both assess the state of family drug treatment courts and build a strategy for the future, the focus group identified the courts’ perceived strengths and the challenges, opportunities, and threats facing them.
Strengths
• Early assessment and service plans. • Judicial leadership (albeit a challenge to keep everyone on the bench in step with change). • Courtroom style—proactive judicial involvement in the case. • Collaboration among service providers and a nonadversarial approach. • Careful documentation of activity, leaving no doubt as to whether reasonable efforts (as defined by the Adoption and Safe Families Act of 1997) have been made. • Frequent contact with parents, regular meetings, and routine hearings. • Ability to avoid being in violation of ASFA requirements by providing services early and achieving a positive outcome. • Ability to identify truly abandoned children early on. • Coordination and integration of services. • More efficient case management over long periods of time. • Motivated clients. • Early identification of clients who are likely to succeed and those who are not likely to succeed. • Clients with similar characteristics (screening criteria). • Ability to identify inconsistencies in the child welfare system. • Policy of treating clients with dignity and respect. • Dedicated staff, which leads to consistency in approach and indepth understanding of clients. • Clients’ positive perception of legal system. • Family drug treatment court parents who help each other succeed.
Challenges
• Tendency to associate a court with the personality of a particular judge; incumbent on judge and team to groom their replacements. • Fragility of clients in the first 30 to 90 days. • Tendency to objectify all standards for admission into FDTC (intuition must play a part in determining whether someone is ready). • Immediate aftermath of an arrest or a child’s removal from the home. • Limited number of spots in the program. • Territoriality issues among the collaborators. • Limited time for inpatient treatment due to managed care rules.
70 • Decline in Medicaid patients (as clients lose children, they lose access to Medicaid, and it happens more quickly under ASFA). • Obtaining buy-in from other members of the judiciary. • Locating housing for parents (after children are removed). • Limited treatment capacity; the need to work with the treatment community to increase sensitivity to the needs of this population. • Getting systems to work with one another and to treat the client as one person, not several individual parts. • HIV-positive clients. • Ex parte nature of some communications in other forums (e.g., divorce cases). • Resistance among parents’ attorneys (though this is beginning to change as attorneys begin to understand the court); need to educate attorneys about FDTC. • Confidentiality. • Ethical issues. • Due process issues. • Deferring to the skills and knowledge of other team members.
Opportunities
• To use ASFA as a motivational tool. • To provide cross training or multidisciplinary training. • To work together to find ways to help parents and families and keep children safe. • To learn the important roles that other people play in the lives of recovering families and to recognize court professionals’ own limitations. • To initiate reforms in related areas. • To learn how other people perceive our clients. • To learn from collaborating professionals at staffings. • To give healthy, safe, clean, and sober parents back to their kids. • To expose the underfunding of child welfare systems and the need to redirect money into those efforts. • To learn how a client’s arrest creates opportunity out of crisis.
Threats (External)
• Damaged relationship with foster care community due to time limits imposed by ASFA. • Threats by parent advocates who maintain that parents should not cooperate with FDTCs (i.e., parent advocates, not a parents’ attorney). • Placement of a child in kinship care as an excuse not to go forward with a permanency plan. (This is akin to placing kids in a black hole and forces us to focus only on kids in paid foster care. Parents are in and out of their lives; nothing changes for them.) • Political risk of taking persons with questionable backgrounds, such as drug dealers, into the program. • Lack of understanding of FDTCs and the accountability that is essential to their success.
71 • Potential for issues to become political. • Funding (funding is often subject to the political climate). • Lack of education about FDTCs among professionals and the community at large. • Perceived lack of good outcome data.
72 Appendix F: Focus Group Participants
Participating Family Drug Treatment Court Practitioners
Jackson County Family Court Kansas City, Missouri Judge
The Honorable Molly M. Merrigan Commissioner Jackson County Family Drug Court Treatment Specialist
Carla Ingram Program Manager North Star Women and Children Child Welfare Specialist
Penny Howell Drug Court Program Manager Jackson County Family Drug Court Guardian Ad Litem
Kyla Grove Jackson County Family Drug Court
San Diego County Superior Court Juvenile Court Division San Diego, California Judge
The Honorable James R. Milliken Presiding Judge, Juvenile Division San Diego Superior Court Treatment Specialist
Kimberly Bond Chief Operating Officer Mental Health Systems, Inc. Deputy Alternate Public Defender
73 Rosalind Gibson Alternate Public Defender’s Office Project Manager
Andrea Murphy San Diego Superior Court
Second Judicial District Court Reno, Nevada Judge
The Honorable Charles M. McGee Judge Second Judicial District Court Treatment Specialist
Kristen O’Gorman Director of Administration and Counselor CHOICES Child Welfare Specialist
Elise Henriques Social Services Practitioner Washoe County Social Services Deputy Public Defender
Cynthia Lu, Esq. Washoe County Public Defender’s Office
Suffolk County Family Treatment Court Central Islip, New York Judge
The Honorable Nicolette Pach Family Court Judge Suffolk County Family Treatment Court Treatment Specialist
Eileen Davies Case Manager EAC Child Welfare Specialist
74 Christine L. Olsen Project Director Suffolk County Family Treatment Court Attorney
Kathy Phillips, Esq. Legal Aid Society
Other Participants
Lolita R. Curtis Vice President National Association of Drug Court Professionals
Bruce Fry, J.D. Social Science Analyst Center for Substance Abuse Treatment Substance Abuse and Mental Health Services Administration
Robin Kimbrough, J.D. Research Associate/Professor Institute on Family and Neighborhood Clemson University
Eva Klain, J.D. Director Court Improvement Project American Bar Association
Marilyn Roberts Former Director U.S. Department of Justice Office of Justice Programs Drug Courts Program Office (now part of BJA)
Kathleen R. Snavely Director of Research National Drug Court Institute Consultant
75 Betsy Earp Consultant/Writer ROW Sciences, Inc.
Deborah Kaufman Research Associate ROW Sciences, Inc.
Ali Manwar, Ph.D. Social Science Analyst Center for Substance Abuse Treatment Substance Abuse and Mental Health Services Administration
Shirley Rhodus Division Manager El Paso County Department of Human Services Colorado Springs, Colorado
Steve Zentz, Esq. Colorado Springs, Colorado
76 Appendix G: Other CSAT Resources
The following documents include other CSAT publications (treatment improvement protocols and companion products based on them) that may be of help to FDTCs. These documents can be obtained from the Substance Abuse and Mental Health Services Administration’s National Clearinghouse for Alcohol and Drug Information (NCADI) at 800–729–6686 (TDD 800–487– 4889) or from CSAT’s Web site at www.csat.samhsa.gov. The NCADI publication number is provided.
TIP 12, Combining Substance Abuse Treatment With Intermediate Sanctions for Adults in the Criminal Justice System, BKD144 • Quick Guide for Clinicians Based on TIP 12, QGCT12 • KAP Keys Based on TIP 12, KAPT12
TIP 17, Planning for Alcohol and Other Drug Abuse Treatment for Adults in the Criminal Justice System, BKD165 • Quick Guide for Clinicians Based on TIP 17, QGCT17 • KAP Keys Based on TIP 17, KAPT17
TIP 21, Combining Alcohol and Other Drug Abuse Treatment With Diversion for Juveniles in the Justice System, BKD169 • Quick Guide for Clinicians and Administrators Based on TIP 21, QGCA21
TIP 23, Treatment Drug Courts: Integrating Substance Abuse Treatment With Legal Case Processing, BKD205 • Quick Guide for Administrators Based on TIP 23, QGAT23
TIP 25, Substance Abuse Treatment and Domestic Violence, BKD239 • Quick Guide for Clinicians Based on TIP 25, QGCT25 • KAP Keys Based on TIP 25, KAPT25
TIP 30, Continuity of Offender Treatment for Substance Use Disorders From Institution to Community, BKD304 • Quick Guide for Clinicians Based on TIP 30, QGCT30 • KAP Keys Based on TIP 30, KAPT30
TIP 36: Substance Abuse Treatment for Persons With Child Abuse and Neglect Issues, BKD343 Quick Guide for Clinicians Based on TIP 36, QGCT36 KAP Keys Based on TIP 36, KAPT36
77 Notes
1 Nonmedical services are performed by those not in the medical profession, such as counselors or social workers, and include services not provided by a hospital or clinic. The welfare-to-work program specifically targets individuals who require substance abuse treatment for employment and allows nonmedical substance abuse treatment as an activity under job retention and support services. 2 P.L. 105-89, signed into law on November 19, 1997, amending Titles IV–B and IV–E of the Social Security Act. 3 The DHHS document Permanency for Children: Guidelines for State Legislation (in development) recommends that the deadline be clarified in state statute as 12 months from the date of adjudication. 4Commentary to Section 1355.20, Federal Register, vol. 63, no. 181, September 18, 1998, p. 50072. 5One Person Family Therapy, Family Effectiveness Training, Bicultural Effectiveness Training, Structural Ecosystems Therapy, and Structural Ecosystems Prevention have all been developed based on the BSFT model.
78 References
Administration for Children and Families and the Substance Abuse and Mental Health Services Administration. 1999. Blending Perspectives and Building Common Ground: A Report to Congress on Substance Abuse and Child Protection. Washington, DC: U.S. Department of Health and Human Services.
Drug Court Clearinghouse and Technical Assistance Project at the American University. 1998. Juvenile and Family Drug Courts: An Overview. Washington, DC: U.S. Department of Justice, Drug Courts Program Office.
Kelleher, K., M. Chaffin, J. Hollenberg, and E. Fischer. 1994. “Alcohol and Drug Disorders Among Physically Abusive and Neglectful Parents in a Community-Based Sample.” American Journal of Public Health 84(10):1586–1590.
National Association of Drug Court Professionals Drug Court Standards Committee. 1997. Defining Drug Courts: The Key Components. Washington, DC: U.S. Department of Justice, Drug Courts Program Office.
National Center on Addiction and Substance Abuse. 1999. No Safe Haven: Children of Substance-Abusing Parents. New York: Columbia University.
National Conference of State Legislatures. 2000. Linking Child Welfare and Substance Abuse Treatment: A Guide for Legislators. Denver, CO.
National Council of Juvenile and Family Court Judges. 2002. Adoption and Permanency Guidelines: Improving Court Practice in Child Abuse and Neglect Cases. Reno, NV.
National Council of Juvenile and Family Court Judges. 1998. Judge’s Guidebook on Adoption and Other Permanent Homes for Children. Reno, NV: U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention.
National Council of Juvenile and Family Court Judges. 1995. Resource Guidelines: Improving Court Practice in Child Abuse and Neglect Cases. Reno, NV.
National Council of Juvenile and Family Court Judges, Child Welfare League of America, Youth Law Center, and National Center for Youth Law. 1987. Making Reasonable Efforts: Steps Keeping Families Together. San Francisco, CA: Edna McConnell Clark Foundation.
Office of Juvenile Justice and Delinquency Prevention. 1994. Strengthening America’s Families: A User’s Guide. Washington, DC: U.S. Department of Justice.
P.L. 105-89, signed into law on November 19, 1997, amending Titles IV–B and IV–E of the Social Security Act.
79 Tauber, J., and K. Snavely. 1999. Drug Courts: A Research Agenda. Washington, DC: U.S. Department of Justice, National Drug Court Institute.
Urban Institute. 1999. Review of Specialized Family Drug Courts: Key Issues in Handling Child Abuse and Neglect Cases. Washington, DC.
U.S. Department of Health and Human Services. April 2001. Adoption and Foster Care Analysis and Reporting System. Fact sheet. Washington, DC.
80
BUREAU OF JUSTICE ASSISTANCE (BJA) DRUG COURT CLEARINGHOUSE
Subject: Comments From Four Family Drug Court Judges Regarding Goals and Evaluation Criteria for Family Drug Courts Prepared by: Caroline S. Cooper, Director, OJP Drug Court Clearinghouse Date: October 23, 2002
The following are comments from four family drug court judges regarding two commonly asked questions:
(1) What appear to be the primary motivations for participants to enter family drug courts?
(2) What are the principal criteria B from the court=s perspective -- that should be used to evaluate the effectiveness of family drug courts?
It is evident that all of the judges appear to be in very close agreement on both issues while, at the same time, approach them from diverse perspectives.
The judges responding were:
Judge Jeri Cohen, Dade County (Miami), Florida Judge Charles McGee, Washoe County (Reno), Nevada Judge Nicolette Pach, Suffolk County (Central Islip), New York Judge John Parnham, Escambia County (Pensacola), Florida
************
1. Based on your experience, what do you feel is the primary motive(s) for participants to enter the family drug court?
Judge Cohen: AI think that the primary motivating factor for parents entering drug court is to get children back. Although they can do this without drug court, I believe their lawyers tell them that the services in drug court are outstanding and that without drug court they will not be successful. In addition, our DC&F is terrible. The attorneys have seen over the years how DC&F actually works to hinder the parents rather than help them. Our addiction specialists essentially babysit these parents for 12 months. In addition, drug court helps parents get preferred placement in maternal addiction centers and, because we have so many eyes on the parents, quicker reunification. For example, I can put my parents into sober housing after treatment with children because I have a structured and monitored environment.@
Judge McGee: AI feel the primary motive for participants entering the Family Drug Court is the assurance of getting their children back if they get clean and sober and satisfy the case plan.@
Judge Pach: Based on my telephone conversation with Judge Pach, she cited the following factors which she felt motivated parents to participate: fear of losing their child; and actually losing their child. She also cited the encouragement which the defense bar gives for participation. Under ASFA, the family drug court presents the parents= best hope of reunification with or maintaining custody of their child; the service plan developed is consistent with ASFA requirements. If a parent doesn=t participant, their case will go into the neglect docket with only the support of an overworked case worker, with minimal services. When they come back for a permanency hearing, little will have been accomplished.
Judge Parnham: Based on my telephone conversation with Judge Parnham, he indicated that, under the new system applicable to the Escambia County Family Drug Court B which makes program participation voluntary -- the primary motivating factor for parents= entry appears to be the desire to regain custody of their children. However, he also noted that, under the previous Asemi-coercive@ system in which a jail sentence could be imposed for a finding of contempt for failure to comply with a dependency court order, which sentence would be suspended if the participant agreed to participate in the family drug court, the desire to avoid jail appeared to be the primary motivating factor. He also noted that, with the shift to a purely voluntary program, far fewer participants now enter the family drug court since all entities involved in the case (defense, case workers, the Department of Social Services, etc.) need to support the family drug court option; if one entity doesn=t support that option, the client doesn=t enter the program.
3. What are the principal criteria you would use to assess the effectiveness of the family drug court (from the court=s perspective, that is)?
Judge Cohen: AThe success of a particular case should be judged not so much based on whether a parent gets all of his/her children back, but rather whether the parent can make good decisions with the drug court on safe permanent placements for the children. This would include giving some children up for relative/stranger adoption; leaving some/all children with relatives but being a helper; getting custody of the children and breaking the cycle of violence, substance abuse and neglect. The primary goal is safe, permanent and nurturing homes within the statutory time frames.@
Judge McGee: AThe principle criterion to assess the effectiveness of the court will be the longitudinal study to show whether or not these people are able to maintain their sobriety and their parenting skills. In another sense, however, the Family Drug Court is even a success as it fails to reunify children with parents. If the intensive efforts at reunification don't work, then the judge can at least honestly and with good faith certify reasonable efforts at reunification before proceeding to a termination of parental rights.@
Judge Pach: Based on my telephone conversation with Judge Pach, she noted that the primary criteria she would look at is the outcome for the child and, particularly, the length of time that elapses until a permanent plan for the child is in place when the child is in a permanent safe and stable home. She would also look at how long it takes to complete assessments and get meaningful services delivered. She, too, noted that the focus can=t simply be on reunification or parental sobriety. While reunification is the preferred permanency plan, the court must focus on timely permanency for children.
Judge Parnham: Judge Parnham indicated that he agreed with Judge Cohen=s comments in this regard. He also noted that, because of the bifurcated design of the Escambia County Family Drug Court, Athe best interests of the child@ aren=t addressed in the family drug court component of the dependency process. These are addressed in a separate, traditional adversarial dependency hearing, in which parties are represented, with prior notice given, etc.. The Abest interests of the child@ are therefore always the consideration and the reason the case is in the dependency court. However, decisions that affect dependency issues (e.g., termination of visitation, reunification, placement of the child, etc.) are made in the dependency component of the proceedings. The focus of the family drug court component of the dependency case process is upon assisting the parent in changing his/her lifestyle that necessarily affects the child Bnot making decisions regarding the placement of the child or reunification B decisions which remain in the traditional dependency process. Given the context in which the family drug court operates in Escambia County, Judge Parnham therefore cited as the primary criteria he would use to evaluate the success of the program is the degree to which the parent makes lifestyle changes that affect the child -- becoming clean and sober; securing/maintaining employment; developing parenting skills, etc.
Judicial Perspectives on Family Drug TreatmentTreatment Courts
BY JUDGE LEONARD P. EDWARDS AND JUDGE JAMES A. RAY
A B S T R A C T FamilyFamily DrugDrug TreatmentTreatment CourtsCourts areare a specializedspecialized calendarcalendar oror docketdocket FamilyFamily DrugDrug TreatmentTreatment CourtsCourts success. This article is thatthat operatesoperates withinwithin thethe juvenilejuvenile dependencydependency court.court. TheseThese courtscourts (FDTCs),(FDTCs), aalsolso kknownnown aass jjuve-uve- intended to give judges and F provideprovide t thehe s settingetting f foror a c collaborativeollaborative e effortffort b byy t thehe c courtourt a andnd a allll nile dependency drug treat- others a judicial perspective thethe pparticipantsarticipants iinn tthehe cchildhild pprotectionrotection ssystemystem ttoo ccomeome ttogetherogether iinn a ment courts, are a special- on FDTCs, and to offer some ized calendar or docket that non-adversarialnon-adversarial settingsetting toto determinedetermine thethe individualindividual treatmenttreatment needsneeds ofof assistance for those who are operates within the juvenile substance-abusingsubstance-abusing parentsparents whosewhose childrenchildren areare underunder thethe jurisdictionjurisdiction ofof operating or who are consid- dependency court.1 FDTCs thethe ddependencyependency ccourt.ourt. TThishis aarticlerticle iiss iintendedntended ttoo ggiveive jjudgesudges aandnd oothersthers ering creating one.6 are not courts in the tradi- a judicialjudicial perspectiveperspective onon FDTCs,FDTCs, andand toto offeroffer somesome assistanceassistance forfor thosethose The article will first tional sense because they whowho areare operatingoperating oror whowho areare consideringconsidering creatingcreating one.one. describe what juvenile depen- do not adjudicate. Instead dency courts do and the need they provide the setting for a collaborative effort by the and purpose for FDTCs within the context of dependen- court and all the participants in the child protection cy courts. Second, it will discuss the creation of FDTCs. system to come together in a non-adversarial setting Third, we will discuss how FDTCs typically operate and to determine the individual treatment needs of sub- some of the issues all FDTCs must resolve. Fourth, we stance-abusing parents whose children are under the will address what we believe makes these courts effec- jurisdiction of the dependency court. The participants tive. Fifth, we will discuss some of the promising innova- in the FDTC work with these parents in an effort to tions that have been developed in FDTC practice. Sixth, rehabilitate them so that they can become competent we will address the difficult challenge of sustaining caretakers and have their children safely returned to recovery for clients after they leave the FDTC. Seventh, their care.2 FDTCs are one of the newest arrivals in the we will examine some evaluative data indicating how drug court world.3 The first FDTC was created in the successful these courts have been, and eighth, we will mid-1990s and several other FDTCs were started a few conclude with some thoughts on the future of FDTCs. years later.4 Today they are one of the fastest growing types of drug courts in the United States.5 I. NEED AND PURPOSE OF FDTCS We are two juvenile court judges who started our A. Juvenile Dependency Courts FDTCs in the late 1990s and have presided over them Juvenile dependency courts7 oversee state interven- ever since. We believe we have enough experience with tion in the lives of abused and neglected children and these courts to describe how FDTCs work, what the their families. When the state intervenes in a family to critical issues are for their creation and maintenance, protect a child from abuse or neglect, the law requires and where they are going. We also believe that there the judicial branch to review the decision to remove is enough evaluative information to declare them a that child from parental care, the decisions concerning
Judge Leonard P. Edwards is the Supervising Judge of the Santa Clara County Juvenile Dependency Court located in San Jose, California, and past presi- dent of the National Council of Juvenile and Family Court Judges. Judge James A. Ray is the Administrative Judge of the Lucas County Juvenile CourtCourt located in Toledo,Toledo, Ohio, andand a pastpast presidentpresident ofof thethe NationalNational CouncilCouncil ofof Juvenile and Family Court Judges.
SummerSummer 20052005 • JuvenileJuvenile andand FamilyFamily CourtCourt JournalJournal 1 Family Drug Treatment Courts
the provision of services to parents whose child has dren do not receive the basic necessities of life. Our been removed, and the decisions relating to the perma- experience, and that of the colleagues with whom we nent placement plan for the child (return to the parent, have consulted, is that the foremost presenting problem termination of parental rights, guardianship, placement for abusive and neglectful parents is substance abuse. with a fit and willing relative, or in another planned per- Research confirms our experience. Estimates are that manent living arrangement).8 from 50% to 90% of all child protection cases have Child protection and child welfare issues are gov- substance abuse as a problem facing the parent or par- erned by federal and state laws.9 These laws describe the ents.16 Substance abuse includes abuse of street drugs, different roles that the executive and judicial branches prescription drugs, over-the-counter drugs, or alcohol. play in the protection of children, the efforts to preserve Usually it is substance abuse that leads to neglect of the families, and the timely determination of permanency child, although on occasion it leads to harm of the child plans for children. One of the unique aspects of these as, for instance, when drugs are sold in the child’s home, laws is that they are sensitive to children’s developmen- when the fetus is exposed to drugs during pregnancy, tal needs. For example, they declare that a permanent or when the child accidentally ingests drugs.17 Other plan for a child must be determined in a short period social and familial problems such as domestic violence, of time, not to exceed one year from the time the child mental health issues, developmental disabilities, and lack is placed in foster care.10 This time frame reflects of parenting and caretaking skills often plague fami- children’s pressing need to live in permanent home as lies, but substance abuse clearly is the most frequently soon as possible so they can develop normally,11 and identified issue facing parents in juvenile dependency also seeks to avoid “foster care drift,” the movement of court.18 We should add that in many cases substance children from one foster home to another.12 abuse is the presenting problem, but by no means the Child protection and children’s services agencies most significant issue facing the parent. Often sobriety are faced with significant challenges in implement- is achieved in a reasonably short period, but other prob- ing these federal and state laws. These agencies must lems such as domestic violence, mental health problems, respond to reports of child abuse and neglect and and housing needs are the issues on which the FDTC determine whether children can safely remain in their court process will spend the majority of its time work- homes.13 If the case is serious, the family may be offered ing with the parent.19 services or the child may be removed from parental cus- Because of the pervasiveness of substance abuse tody. In removal cases, these agencies must then deter- among dependency court clients, we learned early in mine what service plan should be offered to the parents our work as juvenile court judges that if we were going to give them a fair opportunity to be rehabilitated and to be successful in our courts, we would have to man- safely reunited with their children. In a few very serious age substance abuse assessment and treatment issues cases, the court may not order family reunification ser- effectively. We learned that our juvenile courts would vices (reasonable efforts) for the parents to reunify with have to develop a system that could assess substance their child.14 Finally, child protection and children’s abuse levels, design case plans, and have the resources services agencies must find a permanent home for to engage parents in effective substance abuse treat- removed children within a specific time frame. The juve- ment. As judges, each of whom has been sitting on the nile dependency court must oversee all of these events bench for more than 25 years, it took us a rather long to determine whether agency actions have a factual and time to realize that our children’s services agencies and legal basis.15 we as judges did not have the expertise to assess for substance abuse, design treatment plans, or monitor B. The Need for a Family Drug Treatment Court treatment effectively.20 We knew that the parents were Children come before the juvenile dependency unlikely to be able to assess their own needs because in court for a number of reasons. Some are physically most cases they resist acknowledging the extent of their abused, and some sexually abused. Some have parents addiction. Thus, it was a logical step for us to reach out who abandon them or are so neglectful that the chil- to the substance abuse treatment community and invite
2 JuvenileJuvenile andand FamilyFamily CourtCourt JournalJournal • SummerSummer 20052005 Judge Leonard P. Edwards and Judge James A. Ray
them into our courts to create a process in which they his or her parent and that any child who has been in out- would advise us about our clients’ substance abuse treat- of-home care for 15 of the past 22 months should have a ment needs and then provide that treatment. permanent home established immediately. Sadly, national All parents whose children come before the juvenile statistics show that many children linger for years in fos- dependency court are subject to the stringent timelines ter care, some never finding a permanent home.26 set by the Adoption and Safe Families Act. When ASFA We believe that FDTCs shorten a child’s time to was written, some thought that the one-year timeline permanency. This happens for several reasons. First, the for family reunification was too short to give parents substance abuse issue is identified early and treatment a fair opportunity to rehabilitate themselves and have starts early. Second, because of the individualized case their children returned. After all, many of these parents plan and the drug court team’s close monitoring, the had been using drugs for more than 10 years.21 We have parent is more likely to succeed. If the parent fails the learned that the FDTC has the capacity to start treat- program, there is usually no question that reasonable ment quickly and thereby give the parent a chance for efforts have been provided. As a result, the child can recovery even within ASFA timelines.22 In our FDTCs, find permanency in a more timely fashion.27 parents can start treatment almost the first day their Just as adult criminal drug courts have been shown child’s case appears in the court for the initial hearing.23 to save money,28 substantial evidence supports the We believe that for a juvenile dependency court to deal assertion that FDTCs also save money. To the extent competently with substance-abusing parents, the court that an FDTC shortens the time that a child remains and child protection and children’s services agencies in the foster care system, savings in foster care dollars must have continuous access to substance abuse exper- can be realized.29 Judge James Milliken (ret.) of the San tise. This expertise must be available so the court and Diego County Juvenile Court has evaluated the cost sav- the other FDTC members will understand the serious- ings of the FDTC he started more than five years ago, ness of the parent’s substance abuse problem, order a the Dependency Court Recovery Project (The Project). treatment plan that will best meet the parent’s addiction The evaluations conducted by the federal Center for problems, and gain better perspective on the progress Substance Abuse Treatment found that The Project the parent is making in her recovery efforts. “made a dramatic impact on reducing the use and cost of foster care in San Diego.”30 The study showed C. Purposes of a Family Drug Treatment Court a 58% cost savings when The Project was compared to We believe an FDTC has three purposes. The first is traditional child welfare models.31 Evaluations of other to provide a substance abuse assessment and treatment FDTCs have demonstrated similar savings.32 plan in the context of juvenile dependency proceedings Additionally, we recognized that an FDTC could so a parent will have a fair opportunity to recover from order the most effective preventive intervention that a addiction and correct the conditions that necessitated court is capable of providing to addicted parents. Not removal of the child, making it possible for the parent only is the court working with parents (mostly mothers) to reunify with his or her child within the strict ASFA and their children, but most of those mothers are still timelines. The second purpose of an FDTC is to utilize in their childbearing years. We have observed that our the strengths of the drug court process to improve a FDTCs often resemble a nursery, with new births occur- parent’s chances of success in treatment and recov- ring regularly within the client population. Success in ery.24 The third purpose is to provide the client with a an FDTC helps prevent babies from being born to a new vision of life, one that will lead to long-term stabil- substance-abusing mother. ity, and to help each client realize that vision.25 II. CREATION OF FAMILY DRUG D. FDTCs Save Time and Money TREATMENT COURTS Many foster children do not reach permanency in We started our Family Drug Treatment Courts a timely fashion. ASFA declares that a child should be after hearing reports from colleagues regarding the placed in a permanent home in a year after removal from few FDTCs that had been created. We were influenced
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by the success of the criminal drug courts that were the United States.36 We visited criminal drug courts, started in the early 1990s and that have grown and attended their graduations, and discussed their opera- expanded quickly across the country.33 Word of inno- tions with the criminal court judges, the professionals, vations spreads quickly in the juvenile judiciary and and the drug court case managers.37 We learned that particularly among those of us who are involved with there are significant similarities and differences between Court Improvement efforts34 and the Model Courts the two types of drug courts. Some of the similarities are Project of the National Council of Juvenile and Family as follows: Court Judges.35 We have had great success improving ■ 38 our courts by adopting the best practices that have been Both follow the 10 principles of drug courts. developed by colleagues. FDTCs appeared to be another ■ Both develop an individualized plan for each client who appears in court. very promising innovation. ■ Both monitor the progress or lack thereof made by each client. A. Learning from Existing FDTCs We learned that several of our colleagues across the ■ The judges in each court praise those who are doing country had started an FDTC in their jurisdictions. We well, sanction those who are not following the case plan, and encourage all participants. discussed FDTCs with some of our local judges and with ■ professionals who regularly appear in our juvenile depen- Both courts address issues other than substance abuse, including housing, employment, and living dency court, including the attorneys representing each stable lives in the community. of the parties, representatives from children and family service agencies, service providers, court administra- There are significant differences between the two tors, and substance abuse treatment providers. We were types of drug courts. We stress that these differences interested. In Santa Clara County (San Jose), California, must be acknowledged in the operation of a FDTC. Put the local court team visited one of the first FDTCs in another way, an FDTC is not a criminal drug treatment the country, the court that Judge Charles McGee started court in a dependency context. Some of the differences in Reno, Nevada (Washoe County). The trip included 10 between the two types of courts are as follows: people, including a judge, several representatives from the children’s services agency, attorneys who repre- ■ The juvenile dependency court focuses on chil- sented the children, attorneys who represented social dren—criminal drug courts do not. workers, attorneys who represented parents, substance ■ The primary reasons for creating adult drug courts abuse treatment providers, and a court administrator. were: (1) reduction of jail and prison populations and (2) the “revolving door” reflecting adult offend- Each person was able to talk with his or her counterpart ers return to court time after time without ever reha- in the Reno FDTC. Everyone came away believing that bilitating.39 On the other hand, the primary reasons from their perspective the FDTC would be an improve- for creating FDTCs were the pressure for timely ment over what we had been doing before. permanency dictated by the passage of ASFA,40 and In Lucas County (Toledo), Ohio, the Administrative the spirit of the court improvement movement in Judge led a multidisciplinary team to another of the the nation’s juvenile dependency courts. nation’s first FDTCs in Escambia County (Pensacola), ■ The juvenile dependency court must adhere to strict Florida. Each person returned from the trip awed by the timelines—the criminal drug courts have no similar amount of effort required to make the FDTC a success, statutory scheme. The juvenile dependency court but inspired by the possibilities offered by this new must follow the federal time guidelines established under ASFA.41 Pursuant to this law and the state laws court structure. The Toledo team immediately started implementing it, a child who has been removed from planning for its own FDTC. parental care by the state in child protection pro- ceedings must be given a permanent home within B. Learning from Criminal Drug Courts one year of the date the child entered foster care. We also turned to our local criminal drug courts for This time frame creates a great deal of pressure on guidance. Criminal drug courts started before FDTCs all participants in the child protection system, and and have become the fastest growing type of court in particularly on the judge,42 to move the process
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along quickly and to conclude the permanency tal health, domestic violence, and public health process in the one year time frame. This time frame sectors.56 means that there is a sense of urgency in all juvenile ■ An FDTC is much more complex than a criminal dependency matters, including the time by which drug court because all aspects of the client’s life and a substance abusing parent must be rehabilitated. relationships, as well as the ultimate consideration 43 Treatment must start early and it is time limited. of child safety, are part of the rehabilitative pro- ■ The criminal drug courts utilize jail as a primary cess. For example, the Center for Substance Abuse sanction. Some FDTCs use jail, while others do not. Treatment has identified ten kinds of services that Moreover, the purpose of jail may be different in the a drug-dependent mother needs for rehabilitation. two courts. These include: (1) comprehensive screening and ■ The “ultimate sanction” in the criminal court is assessment; (2) medical intervention for women and incarceration while the “ultimate sanction” in juve- their children (e.g., gynecology, HIV, TB); (3) link- nile dependency court is loss of parental rights. ages to federal and state supplementary programs This distinction may make all the difference in terms of (e.g., Head Start, legal aid, job training, TANF); (4) a parent’s motivation to comply with court orders.44 substance abuse and psychological counseling; (5) health education and prevention; (6) educational ■ Most criminal drug court clients are male while and vocational training; (7) transportation; (8) hous- women comprise more than 85% of the clients ing; (9) child care; and (10) continuing care.57 Based 45 in most FDTCs. This gender difference has on our experience, we would add (11) access to par- significant treatment implications. Women’s treat- enting classes and (12) domestic violence services to ment needs are different from men’s, and this has this list. meant that our treatment services have had to be ■ Participation in the criminal drug court can be structured to meet women’s specific needs. Drug- mandatory, but participation in FDTCs is usually dependent women often have low self-esteem voluntary.58 and little self-confidence and may suffer from depression.46 They often have suffered childhood Considering the factors listed, we realized that the trauma, and their drug use may be a form of self- FDTCs could borrow much from the criminal drug 47 medication. They are more likely than men to court, but that the FDTC process had to be designed have co-occurring mental health disorders or be to address the different social and legal aspects of child domestic violence victims.48 Being a victim of vio- lence may increase the likelihood they will engage abuse and neglect cases as well as the special needs of in substance abuse.49 dependency court clients and their children. As a result of these characteristics, women have different treatment needs than men.50 The C. Learning from Juvenile Courts research indicates that the most effective sub- We also relied upon our own experience as juve- stance abuse treatment for women must be com- nile court judges. Juvenile court judges have long been prehensive, should emphasize the “mother-child performing drug court-like functions in their traditional relationship,”51 and should include the children, roles as judges. The FDTC requires judicial leadership to 52 particularly infants, in treatment. Research has bring the court system and service providers together demonstrated that men and women relapse at and to create a collaborative environment. This has been different rates and for different reasons.53 In our FDTC practice we have found that often a wom- the traditional role of the juvenile court judge, that of an’s case plan must include separation from a sig- convenor of court systems and communities on behalf nificant other in her life, usually a man.54 We have of children.59 also found that treatment can be more effective if From our years as juvenile court judges, we knew there are gender-specific services for women such that the FDTC would work well in the context of as programs for mothers with their children and the juvenile dependency court’s goal orientation. AA/NA groups for women only.55 Rehabilitating substance-abusing mothers would result ■ The drug court team is comprised of a different set in better outcomes for children, and the FDTC appeared of professionals in each court. The criminal drug court team is made up primarily of professionals to offer great hope for improving outcomes for sub- from the justice system, while the FDTC will have stance-abusing mothers. Juvenile court judges have many professionals from the social service, men- always been goal oriented. Indeed, the juvenile court is
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the original problem-solving court, and juvenile court alized needs, the efforts of a team of professionals judges have always attempted to identify services and assisting the court, and intense court oversight of strategies to rehabilitate children and family members.60 progress (or lack thereof) by each client. Breaking from the traditional adversarial process, collabora- This oversight and review-of-services role is consistent tive courts utilize team input into judicial decision 61 with juvenile court law. making and focus upon reaching individual goals for each client. They also emphasize a new role for the D. Starting a Family Drug Treatment Court judge, that of problem solver.68 These courts have Starting an FDTC requires several elements, but judi- been given significant recognition and praise by the cial leadership is the first and most important.62 If the Conference of Chief Justices and the Conference of 69 judiciary, or at least one member of the judiciary, is not State Court Administrators. interested in a FDTC, it will not be created. After judicial 3. The FDTC must create a system in which substance- leadership has been identified, that person needs to do abusing parents are identified, assessed, given case plans, monitored during their time before the court, some strategic planning. At the outset, it is important to and given sanctions and encouragement as appro- get permission or a “blessing” from the Presiding Judge priate during the drug court process. Each of these or Supervising Judge of the juvenile court and, depend- stages needs to be developed by a team of profes- ing on the structure of the judicial branch in a particular sionals (the Team).70 The assessment and determina- district, possibly from the Presiding Judge of the entire tion of a treatment plan should come from substance court system. Because of the success of most drug court abuse treatment providers. Case management can be provided either by social workers or substance efforts in the United States, that permission should not abuse treatment professionals. The monitoring, sanc- be difficult to obtain. Once a judicial officer has an inter- tions, and encouragement can be provided by the est and permission from the local judicial branch to court process. create an FDTC, organizational steps must follow. These 4. We have found that frequent cross-training on sub- steps may include the following: stance abuse and other issues relevant to the opera- tion of the drug court and the services needed for 1. The judicial officer should convene the participants drug court clients has assisted in improving every- in the juvenile dependency court system and discuss one’s knowledge about the dynamics of addiction the creation of the FDTC. In our jurisdictions we and recovery and about the need to have substance regularly have meetings that bring together repre- abuse professionals as an integral part of the juvenile sentatives of all professionals who participate in dependency court process. This cross-training also the juvenile dependency court process. We believe helps the substance abuse assessors and treatment that such meetings are beneficial to the administra- providers understand the strict timelines for family tion of the juvenile court and that they provide an reunification dictated by federal and state law. Cross- ideal place to introduce new ideas concerning court training is particularly effective because it brings improvement.63 We introduced the idea of an FDTC professionals from different disciplines together at these meetings and the discussion that followed around issues of common interest.71 It aids in the led to investigation of other FDTCs as well as to con- process of truth finding in the juvenile dependency sultation with professionals involved in those courts. court and reduces some of the adversarial feelings Additionally, the judicial officer can distribute infor- intrinsic to the court process.72 mation about FDTCs during these meetings. Helpful 5. We believe that the judicial officer must take a lead- information and technical assistance are available ership role in contacting and convening the critical 64 from several sources. It may also be useful to show participants as the FDTC is created. For example, 65 a film about FDTCs. the judicial officer must be ready to reach out to the 2. Because FDTCs are collaborative courts, the judicial substance abuse treatment provider community to officer must be prepared to create a collaborative identify what resources are available and who will be environment within the juvenile court. A growing willing to come to the table and be part of the FDTC. body of literature describes collaborative or prob- In Santa Clara County, the judge went to the local lem-solving courts.66 These courts operate under Director of the Department of Alcohol and Drug a different philosophy and with different rules Services and asked him what he believed would be than traditional courts.67 The collaborative court necessary to have adequate resources for an FDTC. approach stresses addressing each client’s individu- Since he had already been working with the criminal
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drug court, he had little difficulty agreeing to work 7. An important step in creating an FDTC involved with our juvenile dependency court plans. working with child protection and children’s ser- In Lucas County, a “joint venture” involving Children’s vices agencies. As dependency court judges, we Services and Alcohol and Drug Addictions Services have always worked with these agencies collabora- (the policy making and funding board) existed tively regarding the administration of justice.75 This before creation of the FDTC. The joint venture pro- collaboration has continued in the creation and vided assessment and treatment referral on demand operation of our FDTCs and has been important for for parents whose children had been removed or several reasons. First, children’s service agencies are were at risk of removal. Since most referrals for ser- very interested in any efforts to improve outcomes vices from Children’s Services were women, most for children and families. These agencies have of the needed resources were in place, especially struggled for years with the problems presented treatment capacity and housing for women. Those by substance-abusing parents,76 and for the court service providers were eager to engage with the to create a system that produces better results for FDTC because they soon learned that compliance families and in a timely fashion is consistent with with the service requirements was far better among agency goals. Second, these agencies are under a FDTC participants. As a result, everyone enjoyed legal mandate to provide “reasonable efforts” to greater success. prevent removal of children, to provide services so We have discovered that the FDTC has required a that separated families can be reunited, and to pro- 77 different array of services than those used by the vide timely permanency for removed children. criminal drug court. As we pointed out earlier, most The FDTC has proved to be an effective means of FDTC clients are women. Thus, the FDTC services providing “reasonable efforts” in providing services must focus on pregnant and parenting mothers, and to families separated from their children. Third, the all service providers must have the capacity to work children’s service agencies in both of our jurisdic- with the child and the mother. Housing resources tions had experienced difficulties communicat- must meet the needs of mothers and their children, ing and working with professionals who provide substance abuse classes should have a mother-child substance abuse services in our communities. The component, and parenting classes likewise must FDTC provided a vehicle for establishing produc- address the needs of young mothers. tive, working relationships between the children’s services agency and substance abuse treatment 6. No drug court will be successful unless it has professionals. As judges, we played an important adequate assessment and treatment services (outpa- role in bringing the children’s services agency tient and inpatient) for the participants.73 Our team together with the substance abuse service com- meetings often address potential sources of support munity in each of our jurisdictions. By keeping the for treatment services and FDTC operational issues. focus on the FDTC’s operations, we helped to avoid We discovered that it was necessary for each of us turf wars and finger pointing.78 to become advocates for substance abuse services and for women in recovery, in particular, as women Finally, there is another important reason for chil- have different treatment needs than men.74 We dis- dren’s service agencies to be involved in the FDTC— covered that a majority of the substance abuse treat- resources. To the extent that these agencies accept ment services in our communities focused upon men responsibility for providing effective substance abuse in recovery. Thus it was necessary to approach our treatment services, they may provide the resources local elected officials and service providers and ask to ensure that those services are present. In Santa for some new services for women and a redistribu- Clara County, the agency is paying for substance- tion of existing services so that women and children abuse experts to provide assessments for substance- were more equitably treated. For example, housing abusing parents as they enter the dependency resources must have the capacity to serve women process and also for housing for substance-abusing in recovery and their children. Traditional housing mothers and their children. Since the children’s ser- for men in recovery does not allow for children in vice agency has access to federal and state funding the living situation. We need to add that advocating to provide such services, the juvenile court should for mothers and infants is much more politically not miss the opportunity to work closely with it to attractive than the more traditional judicial branch maximize the substance abuse treatment resources requests, such as asking for a new courthouse or available for FDTC clients. additional court clerks. There are other sources of funding for drug treat-
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ment and services for FDTC clients. These include 11. We should add that it can be very helpful to have a grants from the federal government, Medicaid, TANF, federal or state grant to support the start-up of an and Title XX of the Social Security Act.79 Additionally, FDTC. Neither of our jurisdictions benefited from state and local resources can support substance such a grant when we started our FDTCs because abuse treatment and even the creation and operation grants were not being offered to FDTCs in those of an FDTC.80 days (only to criminal drug courts). Fortunately, times have changed, and both federal and state gov- 8. Each of us spent considerable time with our drug ernments are beginning to support start-up FDTCs, court teams determining how the FDTC would as well as provide enhancement grants for courts operate. We believe we may have spent too much already in existence.84 time and energy on these issues, but we did not have the benefit of technical assistance from many other courts or national organizations. We believe the pro- III. STRUCTURE, PROCEDURES, cess for starting an FDTC today has been made much AND OPERATIONS easier.81 Some of the issues that the judicial officer A. How an FDTC Operates 85 and the team must address include eligibility for the The typical operation of an FDTC involves a sub- FDTC (which clients will participate in the FDTC stance-abusing parent whose child is before the juvenile and who will not be eligible), when the FDTC cases (calendar) will be heard, who will be a member of dependency court. After the court has sustained a peti- the FDTC team, how information will be commu- tion alleging abusive or neglectful behavior, the client nicated among the various parties and agencies,82 may apply to the court to become a member of the what sanctions and rewards will be offered to clients, FDTC. The client will be assessed by a substance abuse whether entry into the FDTC will be voluntary or treatment assessor to determine the best treatment plan mandatory, and what the relationship between the for him or her.86 If the client is accepted by the court FDTC and the underlying dependency process will 87 be. Some of these issues are discussed below. or by the FDTC Team, the client may sign an agree- ment88 concerning treatment steps he or she will make 9. At some point in the process of creating a new FDTC, the judicial officer and the team must decide and the conditions attached to entry into the FDTC. that it is time to start the court process. We found During the next months (usually a year), the client will that our FDTCs started slowly. Only a few clients appear before the court on numerous occasions with were interested in the FDTC at the start, probably progress reports on treatment successes or setbacks, because it was new and the attorneys representing and the court will provide encouragement, rewards, and parents (and the parents themselves) were cautious sanctions for the client’s actions. After a year (or other about what benefits the FDTC would offer their cli- ents. As the FDTC matured, the attorneys for parents specific time period) of successful participation, the understood the benefits of the court to their clients client will complete the drug court process and will and urged them to join. Social workers also saw the receive some recognition either through a certificate benefits of the FDTC and advocated that their cli- or graduation ceremony. There may be a period of time ents participate. Expanding an FDTC will depend on after graduation during which the client reports back to whether all parties, and particularly the parents and the court to ensure continued sobriety. their attorneys, perceive the court to be beneficial to their interests. Regular team meetings should ensure that all concerns about the court and the processes B. Structure are heard and addressed. Failure to have such meet- FDTCs have many similarities, but they are not ings and to permit all professionals to air their con- identical. They vary in a number of significant ways, cerns could result in creation of an FDTC which has many of which were mentioned in the preceding sec- few or no client participants. tion. Some FDTCs include all substance-abusing parents 10. Some jurisdictions, including both of ours, have whose children are before the juvenile dependency found it useful to develop memoranda of under- court.89 In some FDTCs, the same judge hears criminal standing (MOUs) regarding the roles, responsibilities, and juvenile dependency cases, thus giving the judge duties, and authority among the entities involved with the FDTC. MOUs can be particularly helpful additional power (the criminal sanction) over the cli- when working with agencies that do not have a his- ent.90 Some FDTCs utilize two judges to hear the calen- tory of collaboration.83 dar.91 The length of participation in various FDTCs can
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vary from a few months to over a year. The relationship abuse assessment conducted by substance abuse between the dependency process and the FDTC also treatment providers. Our substance abuse assessors differs from court to court. Some juvenile courts hear have informed us that based on their philosophy the dependency case simultaneously with the FDTC, and training, they will try to work with a client at the treatment level the client is willing to accept. If a while others hold separate hearings. In some, the same client believes that he or she can be successful with judge hears the dependency proceeding and the FDTC outpatient treatment, but the assessor believes that session, while in others different judges hear the depen- residential treatment is necessary, some assessors dency and FDTC sessions. Another structural variation will accept the client’s plan and try to work with involves whether there will be a pre-hearing administra- him or her at that level of treatment.95 tive meeting before the FDTC calendar is called. Both of We suggest that the FDTC should not permit the our FDTCs utilize this type of meeting. We have found client’s assessment of his or her treatment needs to that such meetings are useful to exchange information determine the court-approved treatment plan. We about the progress or lack of progress by each client, insist that the assessor inform the FDTC Team on both and to address general administrative issues. Moreover, the treatment plan the client is willing to participate in and the plan the assessor believes the client needs by having representatives from all participants in the to recover from his or her addiction. The FDTC Team FDTC proceedings present at these meetings, there is almost always adopts the latter assessment. no ethical issue regarding ex parte communications. 4. Content of the Treatment Plan. What should the FDTC case plan include? Should it address only sub- C. Procedures and Operations stance abuse treatment issues? What if domestic vio- For a number of operational issues, FDTCs around lence or other relationship issues are impacting the the country have developed different policies and pro- client? What if housing issues or mental health issues cedures. A discussion of some of these issues follows. face the client? How far should the FDTC Team cre- ate a case plan beyond the substance abuse issues? 1. Determining Eligibility for the FDTC. There is some variation around the country on this issue. We believe that the case plan must start with sub- Some FDTCs admit only women.92 In Santa Clara stance abuse services the experts determine are County, the parent must be receiving family reunifi- appropriate for recovery. They may be outpatient or cation services to be eligible for participation in the inpatient treatment, chemical testing, AA/NA meet- FDTC. This means that a parent who was not offered ings, obtaining a sponsor, completing the 12 steps, family reunification services (reasonable efforts to and other appropriate substance abuse treatment reunite parent and child) is ineligible for the FDTC. interventions. The court would not offer reunification services if Additionally, we believe that effective case planning it found the client ineligible because of aggravated must include a holistic approach to the client and circumstances.93 her situation. We have learned this from operating 2. Signing an Agreement or Contract upon Entry our FDTCs. Clients would appear in court and state to the FDTC. Should the applicant sign a contract that they were clean and sober, but that they had no at the time of entry into the FDTC? Most FDTCs place to live or that their boyfriends were beating are voluntary—that is, the participant agrees to them or that they needed counseling. As a result, enter into the more intensive FDTC by agreeing we learned that to be effective, the treatment plans to participate in the FDTC activities and to follow had to go far beyond substance abuse issues. We the directions of the court and the Team. We have now ask about domestic violence, mental health, found that it is helpful to have a written contract housing, employment, education, driver’s licenses, that the participant, the participant’s attorney, old criminal and traffic warrants, and other aspects and the court each sign at the time of entry. This of the client’s life that might bear upon her ability to contract or agreement indicates what the court’s succeed in life. expectations are concerning the client’s actions If an issue is important to the client, the Team needs while in the FDTC. It lays the foundation for moni- to hear about it and decide whether it will be toring the client’s progress and outlines the pos- included as a part of the case plan. For example, in sibility and severity of sanctions.94 a typical situation, the client (a mother) may be will- 3. Determining the Client’s Treatment Plan. All cli- ing to engage in outpatient treatment, but unwilling ents entering our FDTCs must undergo a substance to leave her boyfriend. The Team will investigate
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to determine whether that living environment will impose sanctions when setbacks occur. Perhaps be supportive of the case plan and goals. When the the most discussed issue among FDTC judges Team learns that the boyfriend has inflicted domes- is whether jail should be used as a sanction for tic violence or that he is still using drugs and is not in lapses in treatment.99 When a client relapses treatment, the case plan will likely direct the mother or fails to follow the case plan, all FDTCs agree to move from that residence, probably to a sober that some sort of sanction is appropriate, but living environment (SLE). The plan may also place the nature of that sanction is the issue. Most restrictions on her contact with her boyfriend.96 FDTCs use incarceration as a sanction. Those who favor the use of incarceration argue that it 5. Voluntary Entrance into the FDTC. Should clients works.100 They further declare that the depen- be able to choose whether to enter and participate dency process and reunification of parents with in the FDTC, or should participation be mandatory? their children is so important that the juvenile In Santa Clara County, participation in the original court has an obligation to get the parent’s FDTC was by application. In the past two years the attention.101 They state that a few days in jail Team has decided to change the model to include all is a trivial consequence when compared to the substance-abusing parents in the FDTC. Some par- permanent loss of a child. They also point out ticipants choose to participate in a more intensive that failure to follow a court order is subject to track of the FDTC, and they do so voluntarily, but the court’s contempt power. A number of those every substance-abusing parent is assessed and given judges have reported to us that parents have a case plan that becomes a part of the court-ordered thanked them for “waking them up” by putting service plan.97 In Lucas County, parents can choose them in jail and getting them back on track for to enter the FDTC. Once a participant has chosen to reunification. Moreover, a California appellate enter the FDTC, however, continued participation is court recently upheld use of jail as a sanction mandatory. Participation is also voluntary in Washoe through the court’s contempt power.102 County, New York City’s Family Treatment Court, the Escambia County (Florida) Drug Treatment Court, If jail time is utilized, it is important to consider the Miami-Dade Drug Treatment Court, and the Erie the framework in which it is being utilized. County (New York) Family Court.98 How does the participant view the time in jail? Is the jail term punishment for failure to comply 6. Responses to Client Participation. One unique or is it an opportunity to reflect about what characteristic of the FDTC is an emphasis on fre- has happened and to plan how to accomplish quent reviews of a client’s progress, which includes personal goals? Used in the latter sense, it can rewards for success in following the treatment plan be more of a “retreat” than a punishment. One and sanctions for failures to follow that plan. judge refers to the jail sanction in his jurisdic- a. Rewards. Courts are not noted for praising or tion as “therapeutic incarceration.” rewarding parties who appear in legal proceed- We caution that when using jail as a sanction, the ings. One does not often hear about judges judge must understand clearly the purpose for praising criminal defendants or civil litigants. any jail sentence and use it only for that purpose. Yet, rewards are a basic ingredient in the FDTC. Most drug court participants are not dangerous in Once the treatment plan has been established, the community and do not need to be detained at each review hearing the judge and other for anyone’s safety. Moreover, just because the jail Team members will discuss the progress (or sanction is utilized extensively and successfully lack thereof) that a participant has demonstrat- in the criminal drug court does not mean that it ed during the time between court appearanc- should be used as widely in the FDTC. es. Different FDTCs around the country have Other courts prefer positive reinforcement developed a variety of rewards from verbal and milder sanctions for clients who relapse praise to tokens to tickets to local community or otherwise get off track.103 They argue that events. From our perspective, these rewards, jail is not necessary. They believe that with the and particularly the words of praise from the proper balance of other sanctions and rewards, judge, support positive change and provide parental motivation can be maximized. Some an effective incentive to continue compliance reflect that jail is an unjust consequence for with the treatment plan. failing to follow the drug treatment plan. They b. Sanctions. Clients sometimes are not successful state that parents do have the right to choose following the treatment plan. Most FDTCs will whether they will reunite with their children
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and can walk away from the dependency pro- cations for successful and unsuccessful parents. The cess, so the judge should not put them in jail successful parent would like to have her progress for choosing not to participate. They point out admitted in the dependency proceedings while the that jail can be seen as demeaning to women unsuccessful parent would not. We have concluded in the FDTC and detrimental to their children that treatment success or lack thereof is admissible who see their parent in jail.104 They also point in the dependency case. out that contempt is not utilized for parents 9. Graduation from FDTC. Should the FDTC acknowl- who fail to go to parenting classes, who do not edge completion of the program? In both of our appear for visitation, or who otherwise do not FDTCs we have a celebration for clients who have participate in the court-ordered case plan. They completed a year of recovery in the program. The argue that failure to engage in substance abuse ceremony is the culmination of successful participa- treatment should not be treated any differently. tion in the drug court experience. For many of our Finally, they suggest that jail is a tempting sanc- clients it is one of the most important moments in tion and will probably be over-utilized by the their lives. Friends and family attend and there are FDTC judicial officer because it is easy. On the speeches and tears. It is a wonderful event. In Santa other hand, they argue, creative sanctions can Clara County, we refer to the event as a graduation. be just as effective as incarceration. The Lucas County FDTC celebrates completion of Whether jail is utilized or not, FDTCs use many the drug court program with a Commencement. The other sanctions when clients are not compli- court explains to the client that the Commencement ant with the treatment plan. In Pima County, marks the beginning of the client’s life and that it will Arizona, for example, the court uses the follow- be the next phase in the client’s recovery process. ing sanctions: (1) restrictions on associations and travel; (2) community service; (3) written Should the drug court honor a client who has par- essays; (4) increased treatment sessions; (5) ticipated in the FDTC, but who has not followed increased court appearances; (6) increased 12- the treatment plan successfully? We recommend step meetings; (7) increased drug testing; (8) up that they not graduate, but be given some acknowl- to 48 hours in jail; (9) residential treatment; (10) edgment of their efforts. One of us offers those cli- delay in graduation to the next level or from the ents a Certificate of Completion rather than a grad- program; and (11) dismissal or suspension from uation certificate. The Certificate of Completion the FDTC.105 Both of our FDTCs also utilize is not given at a ceremony, while Graduation/ these sanctions. Commencement Certificates are awarded as a part of a graduation ceremony. 7. Discussion of Dependency Issues at the FDTC Hearing. The relationship between the FDTC and the 10. The Relationship of Graduation from FDTC and underlying juvenile dependency case is an issue that the Juvenile Dependency Case. Does graduation all FDTCs must address. Should visitation or aspects from the FDTC guarantee that a child will be of the court-ordered case plan be open for discussion returned to the parent? Some courts explain at the and court decision during the FDTC hearing? One of outset of the case that graduation will guarantee a our courts has made the decision that only treatment reunification with the child—others do not. We sug- issues will be discussed at FDTC hearings.106 The rea- gest that the two issues (recovery from substance soning is that the team is addressing treatment issues abuse and reunification with the child) remain sepa- with a unified voice and that only treatment issues rate and not be connected. We tell our clients that are before the court. To inject other issues and the their chances of reunification will be enhanced by possibility of adversarial positions would detract from participation in the FDTC, but that the return of the the collaborative nature of the court process. Other child is a separate issue. courts may handle this issue differently.107 11. Honesty. Should the Team be concerned about par- 8. The Use of Information Gathered in the FDTC ticipant honesty regarding recovery? Yes! Addiction Process in Juvenile Dependency Proceedings. Is and drug use are closely linked to dishonesty. Addicts the parent’s failure to follow the drug treatment lie in order to maintain their lifestyles and avoid plan evidence that can or should be admissible in detection and punishment. We both stress to FDTC the juvenile dependency case? This issue must be participants the importance of honesty. The honesty addressed at the outset of the creation of the drug issue arises regarding all aspects of the participant’s court. Otherwise, unresolved legal issues may arise life from treatment issues, to drug testing, to contact in the dependency proceedings. This issue has impli- with old friends, to daily living. We discuss honesty
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when the client appears on the FDTC calendar and To learn about a client’s situation, the FDTC takes praise clients who admit to transgressions, especially the time to learn the details of the client’s substance when they have not been detected by the Team. We abuse history, including previous treatment episodes, believe that a client’s honesty is one of the criteria preferred drugs, sponsor status, clean and sober date, that will indicate that recovery is taking place. and use patterns. The Team inquires about significant 12. Separate Court File. Should the court system create relationships to determine whether they might impact and maintain a separate file for FDTC cases? In both of our courts, our clerks maintain FDTC records in recovery or lead to relapse. The Team also inquires about the existing dependency file. Other FDTCs create a the client’s living situation and learns about locations in separate file for the treatment court. Creating a sepa- the community where the client has used in the past rate file obviously involves more time and expense, as well as the people the client has used drugs with. but it also separates the treatment plan and progress Additionally, we have learned that it is important to from the dependency issues. Some courts find this separation useful. learn about a client’s family of origin, including those who have substance abuse problems and those who 13. Confidentiality Issues. FDTCs must be prepared to address the issues surrounding confidentiality. Just will be good supports for the client during recovery. as juvenile dependency court proceedings are usu- Throughout the treatment process, the Team will ask ally confidential,108 federal law protects information what problems, if any, the client is facing in her efforts regarding substance abuse treatment.109 Thus it is to remain clean and sober. important for the Team to spend some time develop- The FDTC judge, like the criminal drug court judge, ing information-sharing protocols including releases. takes time to talk with each client and to develop a Examples of these protocols and release forms are available from the authors as well as from most exist- personal relationship with him or her. For most clients, ing FDTCs.110 this is the first time that a powerful person has shown an interest in their well-being. The impact of the judge- IV. THE REASONS FAMILY DRUG client interaction when it is personalized, as it is in the TREATMENT COURTS WORK FDTC, results in greater compliance with the treatment We have spent considerable time and energy start- plan than in court proceedings when the court-client ing and maintaining our local FDTCs. We believe they interaction is less personal.112 From our experience are effective in what they attempt to accomplish: (1) to as well as from the literature,113 we conclude that this provide the appropriate level of treatment services for interaction is one of the most significant motivators for substance-abusing parents in the juvenile dependency the client to change behavioral patterns. The comments court so that those parents will have a fair opportunity we receive include “I have never felt so supported,” “I to reunite with their children in a timely fashion; and (2) couldn’t have made it without you,” and “You really care to provide a unique and effective type of support and about what happens to me.” encouragement for these parents. We also believe that We also believe that frequent appearances before we have some perspective on why these courts work the judge and the Team provide an important continuity and why they will continue to grow. and support for the FDTC client. The federal and state We believe that FDTCs work because, like criminal child protection laws114 mandate hearings every six drug courts, the judge and the other FDTC participants months to review parental progress toward family reuni- treat clients with respect and dignity, fashion individual fication and child welfare. FDTC clients return to court plans for each person, and listen and respond to each cli- on a weekly, biweekly, or monthly basis depending on ent’s problems and concerns. Unlike the ordinary court their treatment progress. Knowing that one is returning process where the judge makes orders, tells clients what for a progress report seems to be a strong motivator to to do, and deals with them on a more or less impersonal comply with the FDTC case plan. Clients return to court basis, the FDTC starts from the premise that each client because they have developed a strong relationship with has individual needs and problems, and that success in the judge and the Team.115 treatment is integrally connected to an understanding of We also have some strategy regarding the frequency the client’s unique situation in life.111 of hearings. At the beginning of the case, the Team
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holds hearings more frequently, often every week. The ian ad litem for the child, the attorney for the parent, the goal at this stage of the treatment process is to get the substance abuse expert, the other service providers, the client into the appropriate housing situation, have her judge, and the client) will be presented and discussed. engaged in treatment, and have her regularly testing, Everyone in the process acknowledges that this is hard attending AA/NA meetings, and securing a sponsor. work, that it takes more time than the ordinary manage- Once the client demonstrates that she is fully engaged ment of court cases, and that it can be exhausting. We in the treatment plan, the hearings can be less frequent, are convinced that, given the enormity of the social and perhaps every two weeks. When the client has dem- personal problems facing most FDTC clients, the extra onstrated that she is fully engaged in treatment and is effort is necessary and appropriate. working to structure a new life, the hearings may be Success of the FDTC also reflects the importance even less frequent, perhaps every three weeks. If there of the underlying issue in all juvenile dependency court cases—reunification with one’s children. We rarely dis- is a relapse or some problems in the treatment plan, the cuss family reunification issues during client appearanc- meetings increase in frequency. es in the FDTC, but everyone knows that success in the Additionally, the frequent hearings also permit the FDTC will maximize a parent’s chances of reunifying court to hold the service providers accountable for the with his or her children. The criminal court uses jail as services promised to the FDTC participant. If the Team the ultimate sanction—the juvenile dependency court’s concludes that a service is important to a participant’s ultimate sanction is more significant, the permanent loss success, then it is expected that the service will be pro- of one’s children. vided. A review in a week or two enables the court to see that the provider has addressed the issue. V. PROMISING INNOVATIONS IN FAMILY The FDTC also ensures collaboration and coordina- DRUG TREATMENT COURTS tion among all service providers in the client’s life. This Our FDTCs are not static. None of them looks any- collaboration is critical to successful service delivery thing like what they were when we started operations and, ultimately, to client rehabilitation.116 As we have in the 1990s. Moreover, we believe that our FDTCs will mentioned, while substance abuse is usually the present- continue to evolve as we learn better ways to engage ing problem in FDTC, we have discovered that domestic clients and motivate them to make significant changes violence, mental health concerns, poverty, housing, in their behaviors. In this section, we will discuss some employment, and other social problems can be equal or of the most promising innovations we have discovered. greater hurdles for the parent. Without identification of these additional problems and coordination among the A. Mentor Moms Program (Santa Clara County) service providers addressing all of the client’s challeng- One of the most challenging issues for any FDTC es, success may not be possible. FDTC brings all these is persuading a client to engage in treatment. Many providers before the court, whose authority ensures clients are in an early stage of readiness to change their that they work together collaboratively.117 pattern of substance use. They deny that they have a The FDTC approach to rehabilitation recognizes substance abuse problem—even if their children have that there are no easy answers to the enduring prob- been removed from them. Often they focus on their lems of substance abuse, domestic violence, and mental anger against law enforcement, social workers, or the health issues. But we also realize that bringing together court system and are unable to face the reality that their a group of experts and service providers in the juvenile substance abuse was a major contributor to their prob- dependency court with a problem-solving mentality can lems in the child protection system. Others simply do build the strongest foundation for the recovery process. not believe they have a substance abuse problem at all The dialogue between the Team and the client creates and that their use of drugs is something that they “can the opportunity for all problems and concerns to be handle” without help. They are in denial. addressed. This interaction builds trust and confidence One program that has assisted mothers in under- between the client and the Team. It also means that each standing and accepting their predicament, and has perspective (that of the social worker, the attorney/guard- assisted them in engaging in substance abuse treatment,
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has been the Mentor Moms Program operating in Santa and its impact on families. Celebrating Families has been Clara County. The attorney office representing parents evaluated and the results demonstrate a high degree of suc- hired several of the first graduates from the FDTC and cess. The program has been replicated in several other sites asked them to work with new female clients. Instead of around the country and in several foreign jurisdictions.123 hearing about the FDTC from an attorney, the new female client will be introduced to a mentor who will explain D. Specialized Social Workers the program and offer herself as a support.118 The fact (Santa Clara County) that the mentor, who is neither a social worker nor an After a few years of working with the FDTC, attorney, can tell the new client that she, the mentor, has the Santa Clara County Department of Family and been through the system has had a significant impact on Children’s Services concluded that the structure of most clients and has helped persuade them to engage in their agency should be modified to reflect the impor- substance abuse treatment and the FDTC.119 The Mentor tance of substance abuse expertise on the social Mom model has been adopted by the Lucas County FDTC worker staff. The director created a new Substance and has been recommended in the literature.120 Abuse Unit of eight social workers, two social worker assistants, and a supervisor. Each of these workers B. Foster Grandparent Program (Washoe County) specializes in cases involving parents with substance In this program, foster grandparents volunteer and abuse problems. Each social worker in this unit sees provide support to families in the program. By tapping the parent on an as-needed basis which often means into the vast resources of the elder community, Washoe weekly contact. They have also learned about effec- County has brought an important group of persons tive techniques to motivate parents toward recovery into the recovery process. By providing almost daily from addiction.124 The recognition of the importance contact with drug court participants, the grandparents of substance abuse as a problem for the agency’s cli- mentor excellence in parenting behaviors that many entele has been tempered by the realization that the parents have never experienced before.121 “Families juvenile dependency system has so many substance- need aftercare options when the program is over and abusing parents that the Substance Abuse Unit cannot it’s difficult for a court to stay involved with the fam- handle all of the cases coming before the FDTC.125 ily. This relationship fills some of that void, and [the Nevertheless, the substance abuse expertise developed bonds] can go on forever.”122 by the social workers in this unit has benefited the entire agency. Lucas County Children’s Services has C. Celebrating Families Parenting Class also developed a specialized social worker unit. (Santa Clara County) Utilizing the resources of a SAMHSA grant, Santa Clara E. CASA Involvement County instituted a parenting class created by experts Many jurisdictions utilize Court Appointed Special in substance abuse and child development. Celebrating Advocates (CASAs) in the FDTC process. CASAs are trained, Families is a 15-week parenting class that brings parents court-appointed volunteers who work with abused and and children together in an enriched environment that neglected children in juvenile dependency cases. The first includes a neurological assessment for each child, Head CASA program was started by a juvenile court judge in Start and Early Start for all the young children, and a cur- 1977, and at last count there are over 940 CASA programs riculum carefully designed to address the special needs of in 49 states.126 Many FDTCs use CASAs to support the substance-abusing parents. The objectives of the classes children of FDTC clients as well as the clients.127 are to: (1) break the cycles of chemical dependency and The FDTC can use CASA volunteers in numerous cre- violence/abuse in families by increasing participant knowl- ative ways. In the District of Columbia Family Treatment edge and use of healthy living skills; (2) positively influence Court, CASA volunteers support children and their moth- family reunification by integrating recovery into daily fam- ers as they move from residential treatment into after- ily life; and (3) decrease participants’ use of alcohol and care.128 With the aid of an enhancement grant, the Santa other drugs and to reduce relapse by teaching all members Clara County CASA129 program has identified a number of the family about the disease of chemical dependency of experienced child advocates who have been provided
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additional training in issues relating to the FDTC process, that we are still learning and that our FDTCs have been substance abuse and recovery, and maintaining appropri- unable to address many problems. For example, some of ate roles. These advocates are assigned to children under our clients relapse. They relapse during the drug court seven years of age and work with the child and the treatment process, they relapse after they have had their mother to help her understand her child’s developmental children returned to their care, and they relapse after needs and support children as they transition into life they have graduated from FDTC and have had their with their substance-free family. The advocates spend dependency cases dismissed from court jurisdiction. time with the mother and child (usually one child at a Substance abuse experts state that relapse is sometimes time) and mentor them regarding parenting skills. Thus a part of the recovery process, but relapses are never- far, all participants are enthusiastic about the results.130 theless significant disappointments for the clients and for all members of the FDTC Team. Their occurrence F. Dedicated Mental Health Services has led us to examine the issues of relapse and sustain- (Santa Clara County) ing recovery and to start to make changes in our opera- After five years of operation, the Santa Clara tions to address these issues. County Team concluded that FDTC clients must have We know that after the case has been dismissed, dedicated mental health services. With at least 50% relapse can occur in many circumstances, but that of FDTC clients having co-occurring mental health several situations reoccur more frequently. Some moth- difficulties, the Team applied for and received grant ers find themselves isolated and alone (albeit with monies that will provide mental health assessments, their children) after the intensive support provided by medication assessments, medications, and therapy. The the FDTC has been removed. Some of these mothers Team is convinced that integration of these mental become depressed and turn to drugs for self-medica- health services into the case plans of FDTC clients will tion and their lives begin to deteriorate. Some mothers significantly improve the outcomes for dual diagnosis return to boyfriends or to the fathers of their children, participants. The Lucas County FDTC team came to the and these relationships do not support their recovery. same conclusion and added mental health services for The boyfriend/father is sometimes using drugs, may be dual diagnosis participants. violent toward the mother and children, or, at times, cre- ates such significant problems in the lives of the mother G. Transportation Support (Santa Clara County) and children that the mother cannot maintain her sobri- Getting around from one program to another, from ety or the lifestyle she developed during her recovery. drug testing to visitation, can be a significant challenge The FDTC response in Santa Clara County has been for a parent with few or no resources. Transportation to try to create connections for drug court clients that can be particularly challenging in a large county. In will last even after the court case is dismissed. This is not Santa Clara County, the Team discovered that many an easy task as the court loses jurisdiction over the child mothers were struggling with transportation. On occa- once it dismisses the case, and there are no legal means sion, the children’s services agency is able to provide of holding the parent accountable for his or her behav- bus passes for the clients, but sometimes the clients ior. The first step we took was to utilize our Mentor found themselves unable to get around the county to Moms as contact persons for FDTC graduates.131 Part complete their treatment programs. The FDTC applied of the Mentor Moms’ responsibilities is to keep track of for and received an enhancement grant that included a modest sum for bus passes for FDTC parents. These have graduates and offer themselves as supports and contacts proved to be a small but effective investment in the should the graduate want help of any kind. The fact that client’s successful completion of treatment plans. many clients have developed a good relationship with the Mentor has made this a successful effort. VI. SUSTAINING RECOVERY— The second step has been to create a number of AN ENDURING PROBLEM events during the year to which graduates are invited We have learned a great deal about substance abuse, to attend. The FDTC sponsors a summer picnic and a recovery, and family dynamics. However, we recognize Thanksgiving dinner. Both have been well attended by
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clients, their children, and by members of the Team. Many Sustaining sobriety in our jurisdictions is a work in graduates also attend. Additional annual events include a progress, but there is hope that these strategies will be Winter Holiday dinner sponsored by Rainbow House, successful. At graduation and dismissal, our clients are a network of homes providing a sober living environ- doing better in their lives than they have for many years. ment (SLEs).132 With the assistance of an enhancement They are highly motivated, are focused on the well-being grant, the leadership at Rainbow House is also starting of their children, and have opportunities for successful a weekly movie night to attract clients and graduates to lives. We believe that our efforts to provide supports for meet in an enjoyable setting. The FDTC is now creating them in the community and in connection with contin- a calendar of events to identify activities throughout ued drug court activities will increase their chances of the year for clients and graduates. The purpose is to lifetime success. provide opportunities for clients and graduates to meet on a regular basis throughout the year in a safe and sup- VII. EVALUATION OF FAMILY DRUG portive environment. The FDTC Team believes that by TREATMENT COURTS A. Evaluation of Results forming positive new relationships with women, FDTC The evaluative data confirms that drug addiction clients will have greater success in recovery in the years treatment is worth its cost.135 Both of our sites have to come. been involved in evaluation of the effectiveness of our The third step has been to identify treatment pro- FDTCs. One of our sites (Santa Clara County) is a part of grams that last beyond graduation from the FDTC and the national study of the effectiveness of FDTCs being dependency court. At first, we relied upon Alcoholics conducted by NPC Research.136 There are many posi- Anonymous and Narcotics Anonymous as the founda- tive findings from this research, including the conclu- tion for lifetime sobriety.133 After time we realized sion that FDTCs are having considerable success in sup- that more supports in the community would increase the opportunities for positive connections for clients. porting parents to enter and remain in substance abuse 137 As a result, we worked to create some AA/NA groups treatment. The evaluation confirms that parents in that were comprised of FDTC clients and graduates. FDTCs are significantly more likely to have at least one Additionally, the FDTC has identified statewide AA/NA treatment entry and have significantly more treatment conferences and provided scholarships for clients and entries than comparison parents. FDTC parents enter graduates to attend these conferences. treatment earlier and spend more days in treatment than 138 Finally, at graduation the judge invites the gradu- non-FDTC parents. Additionally, FDTC parents reuni- ates to return to the FDTC at any time to meet with the fied faster than comparison group parents, and FDTC Team and to keep in contact. In some cases the judge cases reached permanency sooner than the comparison 139 orders the graduate to return as a part of the graduation group cases. process. This happens only in cases with special issues Other evaluations are equally positive. From a where the Team is concerned about the client following national perspective, all FDTCs report a very significant through with a specific task. Other FDTCs around the decrease in drug use by participants once they enter 140 country have structured post-graduation contacts with the program. Additionally, almost all persons com- the court.134 Their existence reflects an acknowledged pleting the FDTC have been able to improve their legal need for client support after the formal drug court pro- relationships with their child or children; approximately cess has officially ended. one half of the participants have been able to retain or In Lucas County, the population is small enough obtain employment, almost 90% receive treatment for that those in recovery and those who have graduated mental health, and approximately one half have devel- from the FDTC get to know each other. They see each oped alumni groups.141 As pointed out above, studies other in their daily lives and participate in meetings have demonstrated that FDTCs can save substantial together. The court also invites them to return to the foster care dollars by reaching permanency sooner.142 FDTC at any time. The result is that community contacts Research has also demonstrated that drug courts have support recovery even after commencement. increased the number of drug-free babies born to FDTC
16 JuvenileJuvenile andand FamilyFamily CourtCourt JournalJournal • SummerSummer 20052005 Judge Leonard P. Edwards and Judge James A. Ray
mothers. We know that many of the mothers who enter Clara County Drug Court Video, “Some people say this is the FDTC will have additional children. The FDTC about mothers getting their kids back. I think it’s more increases the probability that these babies will be born about kids getting their mothers back.”147 We can testify drug free.143 that working in our respective FDTCs has been the most One difficulty with the evaluative efforts has been positive professional experience of our careers. Indeed, the fact that FDTCs are evolving—they are moving tar- we believe that the FDTC process we have described gets. Each of our courts has discovered new and better offers an example of the juvenile court at its best. ways of treating substance-abusing parents, and these changes have been incorporated into our courts. Our VIII. THE FUTURE OF FAMILY DRUG FDTCs operate better today than ever before and they TREATMENT COURTS continue to improve. As FDTCs expand across the coun- For several reasons, we predict that FDTCs will con- 148 try and as judges and other team members exchange tinue to grow and flourish. First, FDTCs work. The ideas, improvements in court operations should con- evaluations demonstrate that substance-abusing parents tinue to accelerate. engage in treatment earlier, they participate in more An additional challenge for evaluators has been to treatment events, and they sustain their sobriety longer identify a control group that can be compared to partici- than any other treatment model we have used. Second, pants in the FDTC. The judge and other members of the juvenile and family court judges across the country are Team are understandably reluctant to permit random actively engaged in court improvement efforts, and the assignments of services to different clients in the same FDTC is an innovation that will continue to attract more court system in order to determine whether one strat- and more attention. Third, the FDTC’s holistic approach egy works better than another. Evaluations are currently is well suited to the juvenile and family courts, where underway to compare similarly sized juvenile court judges are concerned about each client’s success and jurisdictions where one juvenile court utilizes an FDTC well-being of the entire family. The FDTC problem-solv- and the other does not.144 Such evaluations should give ing style ensures that all issues facing the client and the further insight into the effectiveness of FDTCs. family will be addressed. Fourth, it is clear that investing We recommend that any new FDTC integrate evalu- in recovery for women benefits not only the women ation from the outset. Each of our courts can provide themselves, but also the children they have and will technical assistance on the steps to take for evaluation be caring for. This investment also benefits families and of FDTC outcomes, just as the resources mentioned the community as a whole.149 Fifth, the FDTC team earlier can assist.145 approach maximizes collaboration among service pro- viders, which ensures that all of the necessary persons B. Judicial Satisfaction will be able to participate in creating solutions. Sixth, Judges gain great personal and professional satisfac- the FDTC model seeks to engage the community in tion from their participation in all drug courts and from efforts to sustain success after the court case is dis- FDTCs in particular. As we wrote above, drug courts missed. Seventh, technical assistance for creating and have grown very rapidly over the past 15 years.146 One expanding FDTCs is readily available for all jurisdictions, reason for this growth has been the sharing of satisfac- and eighth, FDTC results will continue to bring great tory results among judges around the country. Just as personal and professional satisfaction to the judges and we learned about the possibilities of greater success for all members of the Team. families in the dependency court from reading about America’s juvenile and family courts address the and then visiting other FDTCs, so have hundreds of col- problems facing our most vulnerable children and leagues taken similar steps. their families. Substance abuse may be the most per- When visitors from other jurisdictions come to vasive of these problems, but in reality, each of these visit our courts, they can see that the FDTC environ- families faces many complex issues regarding numer- ment is conducive to change, and that parents are fully ous aspects of their lives. Hundreds of families come engaged in recovery. As one teenager said in the Santa before our juvenile and family courts each day with a
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myriad of problems.150 SuccessfulSuccessful resolutionresolution ofof thesethese tivelytively addr addressess the pr problemsoblems f facingacing substance-a substance-abusingbusing problemsproblems willwill tturnurn oonn tthehe ccreativereative mmodelsodels oourur ccourtsourts familiesfamilies b byy tur turningning to the FDTC pr process,ocess, these cour courtsts designdesign forfor theirtheir responses,responses, thethe collaborationcollaboration theythey will continuecontinue to createcreate and expandexpand FDTCs. GivenGiven the maintainmaintain withwith serviceservice providers,providers, andand thethe positivepositive con-con- stringentstringent time limits requiredrequired byby federalfederal law,law, FDTCs offeroffer nectionsnections theythey cancan encourageencourage betweenbetween familyfamily membersmembers the possibility that substance-abusingsubstance-abusing parentsparents can suc- andand othersothers whowho shareshare thethe desiredesire toto livelive healthy,healthy, sober,sober, cessfullycessfully addr addressess their tr treatmenteatment issues and ha haveve their productive lives. childrenchildren returnedreturned to their car caree within statutor statutoryy time Our nation’ nation’ss juvenilejuvenile and f familyamily courtscourts w weaveeave the limits. FDTCs hahaveve become the most efeffectivefective prprocessocess fabricfabric of our societysociety,, ggivingiving prprotection,otection, hope and oppor- availableavailable to the juv juvenileenile dependency cour courtt to ac achievehieve tunities to our most at-riskat-risk families,families, while at the same success in cases involvinginvolving parentalparental substance abuse.abuse. time holding them accounta accountableble f foror their beha behaviors.viors. TToo WeWe ururgege our judicial colleacolleaguesgues to consider crcreatingeating an the e extentxtent that juv juvenileenile and f familyamily cour courtsts can ef effec-fec- FDTC in their jurisdiction.jurisdiction.
A U T H O R S ’ A D D R E S S E S :
Judge Leonard P. Edwards Superior Court, Santa Clara County 191 North First Street San Jose, CA 95113 E-mail: [email protected]
Judge James A. Ray Administrative Judge Lucas County Juvenile Court 1801 Spielbusch Avenue Toledo, OH 43624 E-mail: [email protected]
AUTHORS’ NOTE: The authors would like to thank Hilary Kushins, Steve Baron, Roxanna Alavi, Julia Lemon, Nancy Marshall, Donna Baldwin, and Bob Garner for their assistance in the preparation of this article.
18 JuvenileJuvenile andand FamilyFamily CourtCourt JournalJournal • SummerSummer 20052005 Judge Leonard P. Edwards and Judge James A. Ray
END NOTES 1 In this article, an FDTC does not include all civil drug relative, or placement in another planned permanent liv- courts, but only those that operate in the juvenile depen- ing arrangement (in a foster home or in a group home). dency court. Thus, a drug court in the Domestic Relations Return to a parent and adoption are the preferred perma- Court would not be considered an FDTC. nent placements, while placement in another planned per- manent living arrangement is an option only to be taken 2 A Family Drug Treatment Court has been defined as when the agency has documented a compelling reason “a drug court that deals with cases involving parental that none of the other options would be in the child’s best rights, in which an adult is the party litigant, which interest. The Adoption and Safe Families Act of 1997, 42 come before the court through either the criminal U.S.C.A. sections 675(5)(C) and 1305 [hereinafter ASFA]. or civil process, and which arise out of the sub- stance abuse of a parent.” Juvenile and Family Drug 9 The federal laws include the Child Abuse Prevention Courts: An Overview, Office of Justice Programs Drug and Treatment Act of 1974 (CAPTA), 42 U.S.C. sec- Court Clearinghouse and Technical Assistance Project. tion 5103(b)(2)(G), The Adoption Assistance and Child (1998), available at http://www.ncjrs.org/html/http://www.ncjrs.org/html/ Welfare Act of 1980 (AACWA), 42 U.S.C. section 670 et. bja/jfdcoview/dcpojuv.pdf [hereinafter Juvenile and seq., ASFA, Pub. L. No. 105-89, Sec. 103 Stat. 2115 (codi- Family Drug Courts]; “A family dependency treatment fied as amended in scattered sections of 42 U.S.C.), and court is a collaborative effort in which court, treat- the Indian Child Welfare Act (ICWA) Title 25, U.S.C. ment and child welfare practitioners come together sections 1901-1963. Each state has its own statutes that in a non-adversarial setting to conduct comprehensive implement the federal law and integrate it into existing child and parent needs assessments. With these assess- state statutory schemes. ments as a base, the team builds workable case plans that give parents a viable chance to achieve sobriety, 10 ASFA, supra note 8. In some states, the time for family provide a safe nurturing home, become responsible reunification has been reduced to six months for children for themselves and their children, and hold their fami- under three years of age at the time of the filing of legal lies together.” Family Dependency Treatment Courts: proceedings. California Welfare and Institutions Code sec- Addressing Child Abuse and Neglect Cases Using tion 361.21(d), (West, St. Paul, 2005). the Drug Court Model, Bureau of Justice Assistance, December 2004, at 4 [hereinafter BJA-2004]. 11 David Arredondo & Leonard Edwards, Attachment, Bonding and Reciprocal Connectedness: Limitations of 3 There are 132 FDTCs in the United States according Attachment Theory in the Juvenile and Family Court, 2 to the most recent data. Drug Court Activity Update, JOURNAL OF THE CENTER FOR FAMILIES, CHILDREN & THE COURTS, Jan. 1, 2005, OJP Drug Court Clearinghouse, BJA Drug at 109-127, 113-114 (2000); Terry M. Levy & Michael Court Clearinghouse, Justice Programs Office, School Orlans, ATTACHMENT, TRAUMA, AND HEALING: UNDERSTANDING of Public Affairs, American University [hereinafter AND TREATING ATTACHMENT DISORDER IN CHILDREN AND FAMILIES Drug Court Activity]. 1 (Child Welfare League of America, 1998).
4 For information on the creation of the first FDTC, see Judge 12 Foster care drift describes the situation of children lost Charles M. McGee, Another Permanency Perspective, 48 in the child welfare system who move from foster home JUVENILE AND FAMILY COURT JOURNAL 4,4, atat 65-68,65-68, (1997).(1997). to foster home, from placement to placement, without ever achieving permanency. See Marsha Garrison, Why 5 Drug Court Activity, supra note 3. Terminate Parental Rights? 3535 STANFORD LAW REVIEW 423 (1983). 6 In the preparation of this article, we consulted with other judges who operate FDTCs, but the opinions expressed 13 This is no small task. There are over 3,000,000 reports of herein are our own. We must confess that we and all child abuse and neglect each year. NO SAFE HAVEN: CHILDREN judges operating these courts owe an enormous debt of OF SUBSTANCE ABUSING PARENTS 1 (National Center on gratitude to Judge Charles McGee (ret.) who created one Addiction and Substance Abuse, Columbia University, NY, of the first FDTCs, has written extensively about these 1999) [hereinafter NO SAFE HAVEN]. courts, and inspired many others to start their own. 14 Aggravated circumstances, (National Conference of 7 These courts are also referred to as Family Courts, State Legislatures, August 1999), Retrieved Feb. 2, 2004 Children’s Courts, Child Protection Courts, and Abuse and from http://www.ncsl.org/programs/cyf/aggravat.htm; Neglect Courts. We will use the term juvenile dependency California Welfare and Institutions Code section 361.5 courts throughout. (West, St. Paul, 2005).
8 According to federal statutes, there are five possible per- 15 For a more thorough description of the juvenile depen- manent plans for children: return to a parent, adoption, dency process, refer to RESOURCE GUIDELINES: IMPROVING guardianship, permanent placement with a fit and willing COURT PRACTICE IN CHILD ABUSE & NEGLECT CASES (National
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END NOTES Council of Juvenile and Family Court Judges, 1995) [here- standard procedure to determine if substance abuse is inafter RESOURCE GUIDELINES]. present when investigating child maltreatment cases. NO SAFE HAVEN, supra note 13 at 2, 5, 31. We also knew that 16 “…a large percentage of parents who abuse, neglect, parents in these cases did not normally receive referrals or abandon their children have drug and alcohol prob- for substance abuse treatment. NO SAFE HAVEN, supra note lems…. Although national data are incomplete, it is esti- 13 at 5, 31; AOD Survey, supra note 16. mated that substance abuse is a factor in three-fourths of all foster care placements.” LINKING CHILD WELFARE 21 The ASFA timelines can be “an insurmountable barrier for AND SUBSTANCE ABUSE TREATMENT: A GUIDE FOR LEGISLATORS addicted parents unable to enter treatment due to wait- (National Conference of State Legislatures, 2000); Laura ing lists, or for parents in treatment who relapse.” Family Feig, DRUG-EXPOSED INFANTS AND CHILDREN: SERVICE NEEDS AND Drug Courts: An alternative approach to processing POLICY QUESTIONS (U.S. Department of Health and Human child abuse & neglect cases, (Family Drug Practitioner Fact Services, 1990); Kelly Kelleher et al., Alcohol and Drug Sheet of the National Drug Court Institute, 1999). Disorders Among Physically Abusive and Neglectful Parents in a Community Based Sample, 84 AMERICAN 22 “The first step is to ensure that all parents with allega- JOURNAL OF PUBLIC HEALTH, 1999, at 1586, 1588; Alcohol tions of alcohol/drug use receive a thorough standard- and Other Drugs Division, National Council of Juvenile ized assessment (preferably onsite at the court ASAP).” and Family Court Judges, available at http://www.ncjfcj. Kathleen West, Substance Abuse and Permanency org/content/view/256/352/; Norah Lovato & Kelly Mack, Planning: Implementing ASFA When Parental Substance Courts That Heal, CHILDREN’S VOICE (Child(Child WelfareWelfare LeagueLeague Abuse is a Factor, 21-22, THE JUDGE’S PAGE, February of America, 2003) available at http://cwla.org/articles/ 2005, available at http://www.nationalcasa.org/download/ cv0303courts.htm at 1 [hereinafter Courts That Heal]; NO Judges_Page/0502_newsletter_0036.pdf; Substance Abuse SAFE HAVEN, supra note 13, at 2; Alcohol and Other Drug Treatment for Persons With Child Abuse and Neglect Survey of State Child Welfare Agencies, (CWLA, 1997) avail- Issues, Treatment Improvement Protocol (TIP) Series, able at www.cwla.org/programs/bhd/1997stateaodsurvey. (Center for Substance Abuse Treatment, U.S. Department htm [hereinafter AOD Survey]; José Ashford, Treating of Health and Human Services, 2004), at xvii [hereinafter Substance-Abusing Parents: A Study of the Pima County Substance Abuse Treatment].]. Family Drug Court Approach, 55 JUVENILE AND FAMILY COURT JOURNAL, Fall 2004, at 27-37, 28. 23 This is often referred to as the Shelter Care Hearing or the Preliminary Protective Hearing. It usually takes place one 17 “The national incidence for fetal alcohol syndrome is or two days after removal of the child from parental care. 1.9 per 1000 births. Each year, at least 1 in 10 or See RESOURCE GUIDELINES, supra note 15, at 29-44. In some 375,000 babies born in the United States have been FDTCs, the court accepts clients whose children have not exposed to illegal drugs taken by their mother during been the subject of formal state intervention; conversation pregnancy.” Child Abuse and Neglect Statistics from the with Judge John Beliveau from Lewiston, Maine. Clearly, National Committee to Prevent Child Abuse, 1995, at 2; the difficulties with ASFA would not occur in cases in and see FACTS: Substance Abuse and Child Welfare, New which no legal proceedings have been initiated. York State Office of Alcoholism & Substance Abuse Services, available at http:/www.oasas.state.ny.us/ 24 Each of our FDTCs has written a Mission Statement. They pio/publications/fs22.htm; Peter Boylan, Court Asked are available from the authors. Other Mission Statements to Overturn Ruling, HONOLULU ADVERTISER, July 6, 2005. are available from the NCJFCJ where the Permanency Planning for Children Department has created a clear- 18 “Any judge, warden or other person involved in the inghouse of information concerning FDTCs. Contact the criminal justice system will tell you the primary under- NCJFCJ’s PPCD at (775) 784-5300 or the Alcohol and lying reason for the incarceration of a majority of Other Drugs Division at (775) 784-8078. people is involvement with drugs or alcohol.” McGee, supra note 4, at 65. 25 “I believe that implementation of a redemptive type of justice system for drug addicts who are parents has stag- 19 The Santa Clara County FDTC has been keeping data on gering potential.” McGee, supra note 4 at 65; “Goals of its clientele for several years. These data show that 69.6% family drug courts…include helping the parent to become of the clients have domestic violence issues, 34.5% have emotionally, financially, and personally self-sufficient and to mental health issues, and 58.5% have housing issues. On develop parenting and ‘coping’ skills adequate for serving occasion, the FDTC team will conclude that “this is not a as an effective parent on a day-to-day basis.” Juvenile and substance abuse case—this is all about domestic violence.” Family Drug Courts, supra note 2, at 5. Data on these and other issues relating to the client pro- files are available from the authors. 26 As late as 2001, the average length of time a child remained in foster care was 33 months. THE AFCARS REPORT, 20 We knew that we were not alone. National data reveal (Children’s Bureau, U.S. Department of Health & Human that most state child welfare agencies do not make it Services 2003), available at www.acf.hhs.gov/programs/
20 JuvenileJuvenile andand FamilyFamily CourtCourt JournalJournal • SummerSummer 20052005 Judge Leonard P. Edwards and Judge James A. Ray
END NOTES cb/publications/afcars/report8.htm; M. Corrigan, Delays 32 See Section VII of this article, page 16. Deny Justice to Foster Care Kids, DETROIT FREE PRESS, May 25, 2005; Foster Care National Statistics, at 4 (National 33 As of December 2003, there were 1,667 problem-solv- Clearinghouse on Child Abuse and Neglect Information, ing courts including 666 adult drug courts, 268 juvenile National Adoption Information Clearinghouse, June 2003); drug courts, and 112 FDTCs. Huddleston et al., supra FOSTERING THE FUTURE: SAFETY, PERMANENCE AND WELL-BEING note 28 at 9. For a full description of problem-solving FOR CHILDREN IN FOSTER CARE, at 12 (The Pew Commission courts, see G. Berman & J. Feinblatt, GOOD COURTS, (The on Children in Foster Care, 2004). New Press, 2005).
27 James Milliken & Gina Rippel, Dealing With Our #1 Problem 34 Court Improvement programs were started as a result of in Dependency Cases: Parental Substance Abuse, (2005, federal legislation. The Family Preservation and Support available from authors); James Milliken, The Dependency Act (Omnibus Budget Reconciliation Act of 1993, P.L. 103- Court Recovery Project—A Joint Project of the Superior 66) provided for limited federal monies to be distributed Court and the County of San Diego, (March 2001—copy on to each state in order to improve the operation of juvenile file with the San Diego Juvenile Court and available from dependency courts. Although the grants to each state were the authors); and see, generally, Ashford, supra note 16. relatively modest, court improvement efforts have resulted in remarkable changes in juvenile dependency courts 28 C.W. Huddleston, K. Freeman-Wilson, & D. Boone, across the country. See Court Improvement Progress Painting the Current Picture: A National Report Card Report: 2004, (American Bar Association, Child Welfare on Drug Courts and Other Problem Solving Court Court Improvement, National Child Welfare Resource Programs in the United States, May 2004, at 2 (National Center on Legal and Judicial Issues, 2004). Drug Court Institute); ADULT DRUG COURTS: EVIDENCE INDICATES RECIDIVISM REDUCTIONS AND MIXED RESULTS FOR 35 The Model Courts Project is formally called “Improving the OTHER OUTCOMES, (U.S. Government Accountability Juvenile and Family Courts’ Handling of Child Abuse and Office, February 2005), available at www.gao.gov/new. Neglect Cases: A Model Training and Technical Assistance items/d05219.pdf; S. Belenko, N. Patapis, & M. French, Program Development Project.” Currently, the Model Courts Economic Benefits of Drug Treatment: A Critical Project has identified 28 courts nationwide and works with Review of the Evidence for Policy Makers, (Treatment them to improve practice in juvenile dependency cases. Research Institute, University of Pennsylvania, February Both Lucas and Santa Clara counties are Model Court sites. 2005); California Drug Courts Save Millions, GUARDIAN See Model Courts: Improving Outcomes for Abused and UNLIMITED, April 16, 2003. Neglected Children and Their Families, January 2004, (National Council of Juvenile and Family Court Judges). 29 For an analysis of foster care savings resulting from reducing a child’s time in foster care by implementing 36 On the history of criminal drug treatment courts, see P. Hora, improved court procedures and policies, see Gregory W. Schma, & J. Rosenthal, Therapeutic Jurisprudence and Halemba, Gene Siegel, Rachael Gunn, & Susanna Zawacki, the Drug Treatment Court Movement: Revolutionizing The Impact of Model Court Reform in Arizona on the the Criminal Justice System’s Response to Drug Abuse Processing of Child Abuse and Neglect Cases, 53 JUVENILE and Crime in America, NOTRE DAME LAW REVIEW, January & FAMILY COURT JOURNAL, Summer 2002, at 1-20, 17. 1999, 1-85, 7.
30 James R. Milliken, Healing Dysfunctional Dependency 37 In Santa Clara County, a visit to the criminal drug court Courts: An Overview, (copy available from the author). In persuaded the juvenile court judge of the necessity of a San Diego County, for example, from April 1998 to July FDTC. He discovered that the criminal drug court was 2002, the average time from the assumption of jurisdic- much slower than the juvenile court process. Two moth- tion to a permanent placement plan was 16.2 months ers who had already lost their children permanently to the and the average time to reunification was 8.8 months. child protection system were graduating from the criminal These figures compared favorably to the previous time drug court. Clearly, this was not the kind of success that of 45.7 months to permanency prior to the Project. the justice system should applaud. See Leonard Edwards, James Milliken & Gina Rippel, Effective Management Santa Clara County Dependency Drug Treatment Court, of Parental Substance Abuse in Dependency Cases, 5 33 JOURNAL OF PSYCHOACTIVE DRUGS, Oct.-Dec. 2001, also JOURNAL OF THE CENTER FOR FAMILIES, CHILDREN & THE COURTS, found in B.J. Winick & D.B. Wexler (eds.) JUDGING IN A 2004, at 95-107. THERAPEUTIC KEY: THERAPEUTIC JURISPRUDENCE AND THE COURTS, (Carolina Academic Press, 2003), at 39-42, and JUVENILE AND 31 D. Crumpton, S. Worcel, & M. Finigan, Analysis of Foster FAMILY JUSTICE TODAY, Summer 2001, at 16-17. Care Costs from the Family Treatment Drug Court Retrospective Study – San Diego County, California 38 Huddleston et al., supra note 28 at 5; and see PRINCIPLES (NPC Research, 2003). Available from the San Diego OF DRUG ADDICTION TREATMENT, National Institute on Drug County Juvenile Court and from the authors. See also Abuse, NIH Publication No. 99-4180, at first four pages Milliken & Rippel, id. [hereinafter PRINCIPLES OF DRUG ADDICTION].
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END NOTES
39 Judge Charles McGee & Caroline Cooper, Shipping Oars Abuse, 5 COUNSELOR MAGAZINE, THE MAGAZINE FOR ADDICTION and Going to Sails: The First Ten Years of Dependency PROFESSIONALS, 2004, atat 12-17,12-17, availableavailable atat http://www.http://www. Drug Courts, THE JUDGES’ PAGE, at 3, available at http:// professionalcounselor.com/pfv.asp?aid=oct04PTSDSUD. www.ncjfcj.org/publications/JMdrugcourtarticle.pdf. htm; “…research indicates that up to 70 percent of drug abusing women report histories of physical and 40 Id. sexual abuse.” NIDA InfoFacts: Treatment Methods for Women, available at http://www.drugabuse.gov/Infofacts/ 41 ASFA, supra note 8; on whether it is possible to reuni- TreatWomen.html (National Institute on Drug Abuse); fy safely with a substance-abusing parent within ASFA Patrick Zickler, Childhood Sex Abuse Increases Risk timelines, see J. Larsen & C. Lederman, Drug-Exposed for Drug Dependence in Adult Women, 17 NIDA NOTES Infants and the Miami Criteria for Judicial Decisions in 1, available at http://www.drugabuse.gov/NIDA_Notes/ Dependency Cases, INTERNATIONAL JOURNAL OF LAW, POLICY NNVol17N1/Childhood.html. AND THE FAMILY, Oxford U. Press, 2000, at 86-106. 48 U. S. Department of Health and Human Services (2002), 42 ASFA requires the judge to make reasonable efforts find- Mental Health: A Report of the Surgeon General, Substance ings regarding the agency’s actions to ensure that a child Abuse and Mental Health Services Administration, Center reaches timely permanency. for Mental Health Services, National Institutes of Health, “(C) if continuation of reasonable efforts of the type National Institute of Mental Health; Understanding described in subparagraph (B) is determined to be incon- Substance Abuse and Facilitating Recovery: A Guide sistent with the permanency plan for the child, reasonable for Child Welfare Workers, (U.S. Department of Health efforts shall be made to place the child in a timely manner and Human Services, 2005) [hereinafter Understanding in accordance with the permanency plan…” ASFA, supra Substance Abuse]; Blending Perspectives and Building note 8, Section 101(a)(C). Common Ground: A Report to Congress on Substance Abuse and Child Protection, (Department of Health and 43 Edwards, supra note 37. Human Services, April 1999), Chapter 5, 1-2 [hereinafter Blending Perspectives]. 44 “With the success I had seen in the general jurisdiction drug court, where the potential sanction was imprison- 49 S.L. Martin & L.L. Kupper, Substance Use Before and ment, I felt there would be even greater success where the During Pregnancy: Links to Intimate Partner Violence, 29 potential consequence of failure was loss of one’s children. AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE, August 2003, I have found this thought borne out time and time again; at 599-617; M. Tuten & H.E. Jones, A Partner’s Drug-Using with appropriate support and services, most parents will Status Impacts Women’s Drug Treatment Outcome, 70 do anything they can to get their children back.” McGee, DRUG ALCOHOL DEPENDENCY, June 2003, at 327-330; Parenting supra note 4 at 65-66. Issues for Women with Co-Occurring Mental Health and Substance Abuse Disorders Who Have Histories 45 Nationally, as of 2001, 87% of FDTC graduates were of Trauma. (Coordinating Center, SAMHSA Women, Co- women and 13% were men. Caroline Cooper, Viewing Occurring Disorders and Violence Study), available at Family Drug Courts from a National Perspective, http://www.prainc.com/wcdvs/pdfs/Fact%20Sheets/ JUVENILE AND FAMILY JUSTICE TODAY, Summer 2001, at 19. Other%20Fact%20Sheets/Parenting%20Fact%20Sheet%20Fi Some FDTCs are operated exclusively for women includ- nal.pdf [hereinafter Parenting Issues for Women]. ing the District of Columbia and Jackson County (Kansas 50 Glen Hanson, In Drug Abuse, Gender Matters, 17 NIDA City), Missouri. See Judge Anita Josey-Herring & Jo-Ella NOTES 2, 2002, available at http://www.drugabuse.gov/ Brooks, District of Columbia Family Treatment Court NIDA_Notes/NNVol17N2/DirRepVol17N2.html; Intensive Partners with CASA Program, THE JUDGES’ PAGE, avail- Outpatient Treatment for Alcohol and Other Drugs able at http://www.nationalcasa.org/download/Judges_ Abuse, Treatment Improvement Protocol (TIP) Series Page/0502_newsletter_0036.pdf; see also BJA-2004, supra 8, Chapter 5: The Treatment Needs of Special Groups, note 2 at 29. NCADI, available at http://www.health.org/govpubs/ bkd139/8g.aspx; NIDA InfoFacts: Treatment Methods 46 D.L. Haller & D.R. Miles, Personality Disturbances in Drug- for Women, NIDA, available at: http://www.nida.nih. Dependent Women: Relationship to Childhood Abuse, gov/infofacts/treatmentwomen.html; Substance Abuse 30 AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE, 2004, Treatment, supra note 22 at 122. at 269-86; A.S. Landheim, K. Bakken, & P. Vaglum, Gender Differences in the Prevalence of Symptom Disorders and 51 West, supra note 22, at 21; the discovery that women have Personality Disorders Among Poly-Substance Abusers and specific treatment service needs than men is a recent Pure Alcoholics, 9 EUROPEAN ADDICTION RES., 2003, at 8-17. development. Prior to the 1970s, research did not focus on issues specific to women. Andrea Barthwell, Treatment 47 Lisa Najavits, Numbing the Pain: The Link Between of Women, (Presentation at National Conference on Drug Trauma, Posttraumatic Stress Disorder, and Substance Addiction Treatment: From Research to Practice, National
22 JuvenileJuvenile andand FamilyFamily CourtCourt JournalJournal • SummerSummer 20052005 Judge Leonard P. Edwards and Judge James A. Ray
END NOTES Institute on Drug Abuse), available at http://www.drug Methamphetamine Use Disorders: An Update, 23 JOURNAL abuse.gov/MeetSum/TX/TXinfo3.html. OF SUBSTANCE ABUSE TREATMENT, 2002, at 145-150, 147.
52 “…true recovery for a mother usually works only when it 57 Center for Substance Abuse Treatment, U.S. Health and includes her children.” Norma Finkelstein, Ph.D., quoted in Human Services, Practical Approaches to the Treatment Parenting Issues for Women, supra note 49 at 1; R. Mathias, of Women Who Abuse Alcohol and Other Drugs, (1994); P. NIDA Expands Its Research on Addition and Women’s Budetti & M. Haack, An Analysis of Resources to Aid Drug- Health, 10 NIDA NOTES 1, Jan./Feb. 1995; S. Blumenthal, Exposed Infants and their Families, George Washington Women and Substance Abuse: A New National Focus, U., (1993); C.M. McGee, J. Parham, T.T. Merrigan, & M. (U.S. Department of Health and Human Services, Office of Smith, Applying Drug Court Concepts in the Juvenile and Women’s Health); R. Mathias, Mental Health Problems of Family Court Environment: A Primer for Judges, at 2, (C. Addicted Mothers Linked to Infant Care Development, S. Cooper ed., prepared by American University for State 12 NIDA NOTES 1, Jan./Feb. 1997; L. Beckman & H. Amaro, Justice Institute, Washington, D.C., 1997). Patterns of Women’s Use of Alcohol Treatment Agencies, in ALCOHOL PROBLEMS IN WOMEN, 319-348 (S. Wilsnack & L. 58 McGee & Cooper, supra note 39 at 4. Beckman, eds., Guilford Press, 1984) [hereinafter ALCOHOL PROBLEMS IN WOMEN]. 59 Leonard Edwards, The Juvenile Court and the Role of the Juvenile Court Judge, 43 JUVENILE AND FAMILY COURT JOURNAL 53 S. Stocker, Men and Women in Drug Abuse Treatment 2, 1992, at 25-32; Standard of Judicial Administration 24, Relapse at Different Rates and for Different Reasons, 113 California Judicial Council, (West, 2005) [hereinafter SJA NIDA NOTES 4, Nov. 1998; M. Vanicelli, Treatment Outcome 24]; it has not been the traditional role of the criminal or of Alcoholic Women: The State of the Art in Relation to civil court judge. See G. Berman, What is a Traditional Sex Bias and Expectancy Efforts, in ALCOHOL PROBLEMS Judge, Anyways, 84 JUDICATURE 2,2, 2000,2000, atat 78-85.78-85. IN WOMEN, supra note 52 at 369-412; Understanding Substance Abuse, supra note 48 at 19. 60 See generally, Edwards, id., at 26-27; for more on prob- lem-solving courts, see Berman & Feinblatt, supra note 54 As one domestic violence expert stated, “Mixing men and 33, at 31-58; see http://www.ncsconline.org/D_Research/ women in treatment groups will reduce the effectiveness Problem-Solving.html and http://www.ncsconline.org/ of the treatment. There are several compelling reasons to WC/Education/KIS_ProSolRefLstGuide.pdf and links con- have gender based interventions. In our FDTC, 75-80% tained therein. of clients have been victims of domestic violence in at least one relationship. Any conjoint services prior to both 61 “Juvenile court judges are encouraged to…[2] Investigate parties completing domestic violence education/therapy and determine the availability of specific prevention, inter- programs potentially can increase the power and control vention and treatment services in the community for at-risk tactics, including violence. Women who have been victims children and their families; and [3] exercise their authority of domestic violence can be easily triggered for flashbacks by statute or rule to review, order and enforce the delivery and for relapse, by comments, facial expressions and voice of specific services and treatment for children at risk and tones of other perpetrators they have contact with even if their families.” SJA 24, supra note 59 at subsection (e). they have no previous history with those individuals. There are also socialization differences between men and women 62 S. Inada, How to Start A Family Drug Court: Advice From which mixed gender groups are not able to address as effec- Judge James R. Milliken, 18 CHILD LAW PRACTICE 1,1, atat 10;10; tively as gender based group.” Nancy Marshall, M.S., L.M.F.T, D. Marlowe, D. Festinger, & P. Lee, The Judge is a Key to one of the authors in June 2005; See also, Understanding Component of Drug Court, 4 DRUG COURT REVIEW 22,, aatt 11-- Substance Abuse, supra note 48 at 19. 34, 25.
55 “Women in women-only drug abuse treatment programs 63 Holding these administrative meetings has been identi- were more than twice as likely to complete treatment as fied as a best practice. See Leonard Edwards, Improving women in mixed-gender programs.” C. Grella, UCLA Study Implementation of the Federal Adoption Assistance and Looks at Women in Treatment, 14 NIDA RESEARCH FINDINGS Child Welfare Act of 1980, 45 JUVENILE AND FAMILY COURT 6, March 2000. JOURNAL 3,3, 1994,1994, atat 3-28,3-28, 18;18; M.M. Hardin,Hardin, H.T.H.T. Rubin,Rubin, & D.D. Baker,Baker, A Second Court That Works: Judicial Implementation of 56 For example, the Santa Clara County FDTC includes a pub- Permanency Planning Reforms, at 39, (ABA Center on lic health nurse, a mental health expert, and a domestic vio- Children and the Law, 1995); Leonard Edwards, Improving lence expert. See A. Somervell, C. Saylor, & C. Mao, Public Juvenile Dependency Courts: Twenty-Three Steps, 48 Health Interventions for Women in a Dependency Drug JUVENILE AND FAMILY COURT JOURNAL 4,4, 1997,1997, 1-231-23 atat 9-10.9-10. Court, 22 PUBLIC HEALTH NURSING 1,1, atat 59-6459-64 (discussing(discussing thethe Santa Clara County FDTC from a public health nursing 64 Judges can contact the National Center on Substance perspective). On the need for mental health participation, Abuse and Child Welfare, NCJFCJ’s Permanency Planning see R. Rawson, R. Gonzales, & P. Brethen, Treatment of for Children Department, (775) 784-6012; also the
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END NOTES National Institute of Drug Court Professionals or Caroline 76 Blending Perspectives, supra note 48, Introduction, at 2. S. Cooper, Director of the BJA Drug Court Clearinghouse, Justice Programs Office, School of Public Affairs, American 77 For a discussion on the “reasonable efforts” requirement, University (202) 885-2875, http://spa.american.edu/ see Edwards, Improving Implementation, supra note 63 justice/drugcourts.php; National Institute on Drug Abuse at 19-21. (NIDA) at http://www.nida.nih.gov; Center for Substance Abuse Treatment (CSAT) at http://csat.samhsa.gov/; and 78 Collaboration between child welfare agencies and sub- the National Drug Court Institute, http://www.ndci.org/. stance abuse treatment providers has been difficult in many jurisdictions. See Blending Perspectives, supra note 65 A copy of a video of the Santa Clara County FDTC is avail- 48 at 4. able from the authors. 79 BJA-2004, supra note 2, at 24-25. 66 Building a Better Collaboration: Facilitating Change in the Court and Child Welfare System, 8 TECHNICAL ASSISTANCE 80 In California, Judge Stephen Manley, one of the leaders in BULLETIN 2,2, (National(National C Councilouncil o off J Juvenileuvenile a andnd F Familyamily the adult drug court movement, was instrumental in secur- Court Judges, April 2004) [hereinafter Building a Better ing state funding to support the creation and expansion of Collaboration]; Greg Berman & John Feinblatt, Problem- FDTCs in the state. Building on the success of adult drug Solving Courts: A Brief Primer, 23 LAW AND POLICY 22,, 22001,001, courts in California, Judge Manley argued persuasively to also available at www.courtinnovation.org. the California State Legislature that FDTCs will be as effec- tive as adult drug courts and will save the state foster care 67 Id. dollars.
68 Id., and for a detailed discussion of the role of the juvenile 81 For example, technical assistance is available from The Drug court judge in building a collaboration, see Building a Court Planning Initiative, Family Dependency Treatment Better Collaboration, supra note 66. Court Skills-Based Training Program, Bureau of Justice Assistance and OJJDP, OJP, U.S. Department of Justice in 69 In Support of Problem Solving Courts, Conference of collaboration with the National Criminal Justice Reference Chief Justices CCJ Resolution 22 and Conference of Service and the National Association of Drug Court State Court Administrators, COSCA Resolution 4, Adopted Professionals. Additional technical assistance is available August 3, 2000. from the National Council of Juvenile and Family Court Judges, www.ncjfcj.org; see also M. Wheeler & J. Siegerist, 70 The Team in our jurisdictions includes the judicial offi- Family Dependency Court Planning Initiative Training cer (two in Lucas County), representatives from the Curricula, (National Drug Court Institute, 2003). See also Department, CASA, attorneys for parents, attorneys for the the organizations and technical assistance resources men- Department, attorneys/guardians ad litem for children, a tioned in note 64. public health nurse (Santa Clara County), a mental health expert (Santa Clara County), a domestic violence expert 82 This was a particularly challenging issue for both of our (Santa Clara County), an employment specialist (Lucas and FDTCs. The confidentiality laws for substance abuse treat- Santa Clara counties), and a housing expert. Others may ment providers are different from the laws governing come and participate in the drug court activities on an as- confidentiality of child welfare agency records, and the needed basis. juvenile court’s confidentiality laws are different from both of those. Additionally, the attorneys have their own 71 Edwards, Improving Implementation, supra note 63 at 11. confidential relationships with their clients. We worked through all of this carefully and now believe that a start- 72 Id.; and see BJA-2004, supra note 2, at 27. up court will be able to adopt policies and procedures that ensure the flow of necessary information without 73 “The law requires that we provide reasonable services. The violating any of these laws. See further discussion supra at Court has the authority to order services and must do so Section III, C 13. or parents will not get access to treatment and children 83 Upon request, the authors can provide copies of the MOUs will remain in foster care.” Judge James Milliken, in S. Inada, developed in their jurisdictions. How to Start a Family Drug Court, 18 CHILD LAW PRACTICE 1, at 10-12, 11. 84 OJJDP and SAMHSA have offered grant funding for start- up and enhancement of FDTCs. See http://ojjdp.ncjrs. 74 See the references and text at notes 45-55, supra. org/funding/funding.html.
75 Edwards, Improving Juvenile Dependency Courts, supra 85 This is a composite sketch of the workings of a “typical” note 63 at 9-10. FDTC. Variations exist regarding almost every structural and operational detail, but this sketch attempts to capture a general picture of the FDTC.
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END NOTES 86 The substance abuse assessment is a critical first step. in services that would demonstrate to the court that he Without an accurate assessment, the treatment plan may not can be a safe parent figure. The court may also explain be sufficient to ensure recovery. Both of our jurisdictions that the court is ordering the mother to live in a sober rely on substance abuse experts and not upon social work- living environment (SLE) and ask for his support of this ers to complete the assessment. Additionally, the sooner the plan. This approach has been successful in the majority of assessment is complete, the sooner the treatment can begin. cases in which it has been employed. Judge James Milliken For this reason, attorneys for parents often have their clients (ret.) has also written in a similar vein about the issue of complete the assessment before the court has reached boyfriends/girlfriends. See Inada, supra note 73 at 12. the jurisdictional stage of the legal proceedings. San Diego County uses a similar assessment protocol through the 97 In this regard, Santa Clara County adopted a modification Substance Abuse Recovery Management System (SARMS). of the San Diego model. In San Diego County, every parent See Milliken & Rippel, supra note 30 at 99. with substance abuse issues is assessed by the treatment experts (SARMS), and their progress is reviewed by the 87 The Team usually consists of one or two judicial officers, judicial officer on a regular basis. If the client relapses or a coordinator, substance abuse treatment providers, one fails to follow the treatment plan, the case may be referred or more representative from the Department, and attor- to the Presiding Judge for sanctions, including jail. For a neys for the parent, the social workers, and the child. See more complete description of the San Diego Recovery BJA-2004, supra note 2 at 32-34. The Santa Clara County Project, see the articles in notes 30, 31, and 73, supra. FDTC team has never had a coordinator. The Lucas County Team does have a coordinator as do most FDTCs 98 McGee, supra note 4, at 66; G. Sosa-Lintner, New York City’s we are aware of. For the other members of each team, see Family Treatment Court, JUVENILE AND FAMILY JUSTICE TODAY, note 70 supra. Summer 2001, at 22; Program Manual, at 4, (Erie County Family Court, Family Treatment Court, 2001), available 88 Copies of the Santa Clara and Lucas County client agree- from the Erie County (New York) Family Court, or from ments are available from the authors. the authors.
89 San Diego and Santa Clara counties in California are exam- 99 C. Cooper, Use of Jail Sanctions in Family Drug ples of this model. Courts, Frequently Asked Questions, (BJA Drug Court Clearinghouse, 2005); BJA-2004, supra note 2 at 20. 90 Washoe County, Nevada, is an example of this model. 100 T. Maugh & D. Anglin, Court Ordered Drug Treatment Does Work, THE JUDGE’S JOURNAL, WinterWinter 1994,1994, atat 10;10; S.S. Satel,Satel, 91 Lucas County utilizes two judges to hear the FDTC. Drug Treatment: The Case for Coercion, 3 NATIONAL DRUG COURT INSTITUTE REVIEW 1,1, atat 1-91-9 (both(both ofof thesethese articlesarticles referrefer 92 The District of Columbia and Jackson County, Missouri, are to criminal drug courts). two examples. 101 The San Diego and San Joaquin FDTCs in California, 93 See the references to “aggravated circumstances” supra at Suffolk County in New York, Escambia County (Pensacola) note 14. and Miami-Dade in Florida, Lucas County in Ohio, and the Washoe County, Nevada, FDTCs all utilize jail as a sanction. 94 Copies of the contracts for Santa Clara and Lucas counties are available from the authors. 102 In re Olivia J. (2004); 124 Cal.App.4th 698, 21 Cal. Rptr.3rd 506 [The California Supreme Court has granted review in 95 The outpatient/inpatient treatment decision is one of the this case]. most important that the FDTC Team must make. Research indicates that inpatient treatment may be necessary for a 103 Santa Clara County, California, Manhattan Treatment Court successful outcome particularly in clients who are meth- in New York City, and Jackson County, Missouri, do not uti- amphetamine users. Rawson et al., supra note 56, at 147. lize jail as a sanction, and the Presiding Judge of the newly created FDTC in Omaha, Nebraska, announced at the 96 A strategy that one of us has used is to invite the boyfriend opening ceremony that jail will not be used as a sanction to come to the FDTC and talk with him about the situa- except in rare cases. (Remarks of Judge Douglas F. Johnson, tion facing the mother. The court will ask if he considers Douglas County Family Drug Treatment Court, Omaha, himself to be an important person in the mother’s life and Nebraska, May 26, 2005, available from the author and in the child’s life. If he says “yes,” the court explains that he from Judge Johnson); Nebraska’s Courts Celebrate May as may have a significant impact on the outcome of the child National Drug Court Month With Proclamation Signing welfare proceeding. The court will state that if he is using by Chief Justice at the Opening of the First Family Drug drugs or is being violent toward the mother, it is unlikely Treatment Court in Omaha, (Office of Public Information, that the child would be returned to that environment. The Nebraska Supreme Court, May 24, 2005). court then asks whether he would be willing to engage
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END NOTES 104 This is the position taken in Jackson County (Kansas City), Participation in Agency-Initiated Services, 84 FAMILIES IN Missouri. See BJA-2004 supra note 2 at 20. SOCIETY: THE JOURNAL OF CONTEMPORARY HUMAN SERVICES 4, at 471-479. In the school setting, studies show students 105 Ashford, op. cit. note 16 at 30. The list of sanctions for the with caring and supportive relationships in the school parents in the Suffolk County FDTC can be found at BJA- environment report more positive academic attitudes and 2004, supra note 2 at 21. values and more satisfaction with school. These students also are more engaged academically. A. Klem & J. Connell, 106 In Santa Clara County, the judge presides over both the Relationships Matter: Linking Teacher Support to Student dependency calendar and the FDTC. However, if there is Engagement and Achievement, 74 JOURNAL OF SCHOOL a contested issue (whether the child should be returned HEALTH, Sept. 2004, at 262. home or whether services should be terminated), a differ- ent judge will hear the case. 114 AACWA, CAPTA, and ASFA, and state laws implementing these statutes, supra note 9. 107 The Pima County FDTC is a separate calendar from the dependency calendar. The FDTC judge provides over- 115 E. Pyle, Addicts Can Change When Someone Cares, Judges sight of treatment progress, not of the dependency case. Say, THE COLUMBUS DISPATCH, JuneJune 2,2, 2002,2002, NewsNews 01B.01B. Ashford, supra note 16 at 29. 116 Inger Sagatun-Edwards & Coleen Saylor, A Coordinated 108 42 U.S.C. section 671(a)(8) (2001); Leonard Edwards, Approach to Improving Outcomes for Substance-Abusing Confidentiality and the Juvenile and Family Courts, 55 Families in Juvenile Dependency Court, 51 JUVENILE AND JUVENILE AND FAMILY COURT JOURNAL, Winter 2004, at 1-25. FAMILY COURT JOURNAL, FallFall 2000,2000, atat 1-16,1-16, 14.14.
109 42 U.S.C. section 290dd-2 (2001); 42 C.F.R. section 2.1 117 “‘[T]eamwork’ is the hallmark of the Family Drug Court,” (2001). McGee, supra note 4 at 67.
110 For a more complete discussion of the confidentiality issue 118 S. Lafferty, Experience Invaluable in Making Mothers in FDTCs, see C. Lu, Family Drug Court: An Alternative See the Light, THE RECORDER (San(San Jose,Jose, CA),CA), Oct.Oct. 10,10, 2000;2000; Answer, 21 CHILDREN’S LEGAL RIGHTS JOURNAL SSpringpring 22001,001, ‘Mentor Moms’ Voted Best New Model Court Idea, JUVENILE at 32, 28; Substance Abuse Treatment, supra note 22 at AND FAMILY JUSTICE TODAY, Fall 2000, at 18. 151-163. 119 For further information on Mentor Moms, contact Gary 111 “It is essential that each case plan be individualized and Proctor, (408) 442-0442. that all services be provided to deal with all problems fac- ing the family.” McGee, supra note 4 at 66. 120 Understanding Substance Abuse, supra note 48, at 19.
112 The evaluative data show that participation in the FDTC 121 Charles McGee, The Washoe County (Reno) Family Drug increases the number of treatment episodes as well as the Court, JUVENILE AND FAMILY JUSTICE TODAY, Summer 2001, at 21. probability of successful family reunification. (see Section VII, pages 16-17). 122 Judge Charles McGee, quoted in Courts That Heal, supra note 16 at 2; for further information about the Foster 113 Experiences in other disciplines confirm the conclu- Grandparent Program, write to Foster Grandparent sion that personalizing the professional-client relationship Program, 1552 C Street, Sparks, NV 89431 or call (775) increases client compliance with professional advice. In 358-2768. medicine, personalizing the doctor-client relationship results in higher compliance with medical instructions. 123 T. Tisch, Celebrating Families: An Innovative Approach E. Sellers, H. Cappell, & J. Marshman, Compliance in the for Working With Substance Abusing Families, 14 Control of Alcohol Abuse, in COMPLIANCE IN HEALTH CARE, THE SOURCE 1 1,, 6 6-10,-10, ( (TheThe N Nationalational A Abandonedbandoned I Infantsnfants chapter 14 (R.B. Haynes, D.W. Taylor, & D. Sackett eds., The Assistance Resource Center). For further information, Johns Hopkins University Press, 1979); D. Falvo, EFFECTIVE contact Rosemary Tisch, PPI Director at (408) 406-0467 or PATIENT EDUCATION: A GUIDE TO INCREASED COMPLIANCE, 2- Deborah Dohse, MSW, (408) 975-5174. 3, 7, 18-22, 65, 128-134, 175-182 (Aspen, 1985). The 124 Understanding Substance Abuse, supra note 48 at 14. development of a positive relationship between a social worker and a parent in treatment also results in bet- 125 For further information, contact Social Worker Supervisor ter compliance with the program expectations and a Joyce McEwen Crawford at Joyce.McEwen-Crawford@ssa. reduction in the likelihood of future child abuse or sccgov.org. neglect. J. Littell, Client Participation and Outcomes of Intensive Family Preservation Services, 25 SOCIAL WORK 126 Leonard Edwards, Ernestine Gray, & J. Dean Lewis, The RESEARCH 2; J. Altman, A Qualitative Examination of Client Judicial Role in Creating and Supporting CASA/GAL
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END NOTES Programs, JUVENILE AND FAMILY JUSTICE TODAY, Spring 2005 136 There are four sites involved in this five-year study: at 16-19, 17. Washoe County (Reno), Nevada; Santa Clara County (San Jose), California; San Diego, California; and Suffolk County, 127 For a summary of some of the FDTCs that utilize CASA New York. volunteers, see The Impact of Parental Substance Abuse in Dependency Cases, THE JUDGES’ PAGE, February 137 Draft Interim Report—Family Treatment Drug Court 2005, available at http://www.nationalcasa.org/down Retrospective Outcome Evaluation Update II, Santa load/Judges_Page/0502_newsletter_0036.pdf; “A CASA Clara County, at p. II (NPC Research, Portland, Oregon, worker assigned to the participant can make the differ- September 2004); Rawson et al., supra note 56 at 149. ence needed for success.” McGee, supra note 4 at 67. 138 Id. 128 Josey-Herring & Brooks, supra note 45. 139 N. Young, Findings from the retrospective phase family 129 CASA stands for Court Appointed Special Advocate. In drug court national cross-site evaluation, (presented at Santa Clara County, the CASA program is called the Child the National Association of Drug Court Professionals 4th Advocate Program. Annual Conference in Washington, D.C., 2003).
130 For further information about the Dependency Drug 140 Cooper, supra note 45 at 20; see also Ashford, supra note Treatment Court Pilot, contact Melissa Santos at 16 at 33. [email protected]. 141 Cooper, supra note 45. 131 See Mentor Moms Program, section V-A, pages 13-14. 142 See Section I-D, page 3. 132 Rainbow Houses are another model deserving atten- tion. Working with the Santa Clara County Department 143 C.W. Huddleston, K. Freeman-Wilson, D. Marlowe, & A. of Alcohol and Drug Services (DADS), Nancy Wilson, an Roussell, Painting the Current Picture: A National Report enterprising woman, has created a network of homes Card on Drug Courts and Other Problem Solving Court for substance-abusing women in the county. With five Programs in the United States, May 2005, at 8-9 (National converted houses and a capacity of 50 beds, Rainbow Drug Court Institute). Houses offer a sober living environment for FDTC clients and their children for up to one year. Typically the client 144 For further information, contact Northwest Professional will enter a Rainbow House alone, and as she progresses, Consortium, Inc., 4380 SW Macadam Ave., Suite 530, her children will be returned to her care. The Rainbow Portland, Oregon 97239. Houses include a number of services for clients and gradu- ates. For further information, contact Nancy Wilson at 145 See notes 64 and 81. Rainbow Recovery Foundation, Inc, 2147 Lincoln Avenue, San Jose, CA 95125, [email protected]; on the 146 Drug Court Activity, supra note 3. importance of housing for women, see Substance Abuse Treatment, supra note 22 at 85. 147 See note 65 supra, regarding the Santa Clara County drug court video. 133 In addition to AA and NA, the clients may go to Cocaine Anonymous (CA), Marijuana Anonymous (MA) and similar 148 There are 153 FDTCs in the United States according to the groups. All use a form of the 12 steps and sponsors to most recent data. Huddleston et al., supra note 143 at 3. address addiction. It is usually required that the client obtain and work with a sponsor. In Santa Clara County, the FDTC 149 Substance Abuse Treatment for Women, November 2004, also accepts Health Realization as a substitute for AA/NA. (United Nations, Office on Drugs and Crime, V.04-53297).
134 Examples include the FDTCs in Florida’s Escambia County 150 Leonard Edwards, President’s Message, JUVENILE AND FAMILY and Miami-Dade, and the Manhattan Family Treatment JUSTICE TODAY, Summer 2003, at 3; Leonard Edwards, Court in New York City. Remarks of Leonard P. Edwards on the Occasion of William H. Rehnquist Awards Presentation—November 135 See Principles of Drug Addiction Treatment, supra note 18, 2004, 56 JUVENILE AND FAMILY COURT JOURNAL, Winter 38; Berman & Feinblatt, supra note 33 at 155-158. 2005, at 45-51, 46.
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KAREN FREEMAN-WILSON, EXECUTIVE DIRECTOR JUNE 2006 VOL. V, NO. 1 188 intheplanningstage. grown to198(Huddleston,Freeman-Wilson,&Marlowe),withanadditional outcomes. ThroughDecember2005,thenumberofoperationalFDTCshas and otherfamilycourtordersnecessarytoimprovechildprotectioncase in bettercollaborationbetweenagenciesandcompliancewithtreatment substance abuseandotherco-morbidityissues.TheFDTCapproachhasresulted environment forthechildwhileintensivelyinterveningandtreatingparent’s do whatisinthebestinterestoffamilybyprovidingasafeandsecure Treatment Courts”(FDTC),whichbeganin Reno,Nevada,in1995,seekto neglect relatedtosubstanceabuse.“FamilyDrugCourts”orDependency court modeltochildwelfarecasesthatinvolveanallegationofabuseor D well-documented (National CenteronAddictionandSubstanceAbuse,1999). The correlationbetweenparental substanceabuseandchildmaltreatmentis 2003 (NationalClearinghouse onChildAbuseandNeglectInformation,2005). the timechildrenspentinfostercarechanginglittle between FYs1998and Year (FY)2003,50percenthadbeenincareformorethan12months,with (ACYF). Oftheestimated281,000childrenwhoexited fostercareduringFiscal a millionchildrenliveinfostercare,withnearly126,000 awaitingadoption has nearlydoubledinthelasttwodecades(ACYF).Currently, morethanhalf 1,000 childrenin2003.Thenumberofout-of-home placement increased to42.6referralsper1,000childrenin2004 from39.1referralsper of children(ACYF).Thenationalratereferralstochild welfareagencies [ACYF], 2006).Ofthosefilings,approximately1,490 cases involvedthedeaths are filedandsubstantiated(AdministrationonChildren,Youth, andFamilies Each yearintheUnitedStates,nearly1millioncasesofchildabuseandneglect T A numberoffamilycourts I FACT SHEET P By MeghanM.Wheeler, M.S.andCarsonL.Fox,Jr., J.D. M A F NTRODUCTION HE AMILY PYN THE PPLYING ALTREATMENT L INK RACTITIONER RUG B ETWEEN D EPENDENCY C HILD D 3 across thenationaresuccessfullyapplyingdrug C RUG ASES M LRAMN AND ALTREATMENT C T OURT REATMENT 2 C OURT M DLIN ODEL S UBSTANCE C OURT C : A HILD 1 BUSE 10697-NDCIFamily FS Rev 6/9/06 4:16 PM Page 2
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THE ADOPTION AND SAFE FAMILIES ACT The FDTC approach has resulted in better Congress passed the Adoption and Safe Families Act (ASFA) in 1997 to strengthen collaboration between agencies and the performance of child welfare systems. Specifically noted, “The passage of this new better compliance with treatment and law gives us an unprecedented opportunity other family court orders necessary to to build on the reforms of the child welfare system that have begun in recent years in improve child protection case outcomes. order to make the system more responsive to the multiple, and often complex, needs of children and families” (Child Welfare League In 80 percent of confirmed child abuse and of America, 2001). ASFA’s primary goal is to neglect cases, experts identify parental sub- provide for the safety, permanent placement, stance abuse as a precipitating factor, which and well-being of children and families (1997). 4 further complicates these already difficult To promote efficiency in permanency planning , and complex cases (Child Welfare League based on the best interests of the child, ASFA of America, 2001). mandates that courts finalize permanent placement no later than 12 months after A parent’s inability to maintain a drug-free a child enters foster care. In addition, in lifestyle and make other significant changes most cases, ASFA requires courts to begin delays reunification with his or her children termination of parental rights after the child and may ultimately lead to the termination has been removed from the home for 15 of parental rights. Families with parents of the last 22 months (Office of the Federal who face alcohol and drug dependency face Register, 2000). Child welfare and clinical additional challenges, including poor housing, experts have expressed concern that the mental and physical health problems, trans- timeframes imposed by ASFA are unrealistic, portation issues, lack of appropriate child given the time necessary for effective treat- care, educational challenges, and lack of ment and sustained recovery of substance- stable employment. Under the more traditional abusing parents. This concern is particularly family court system, a disconnect often exists troubling, considering that waiting lists at between the family court, child protection treatment facilities are not uncommon. caseworkers, and drug treatment services, leading to uncoordinated and limited services, Without access to appropriate treatment, which further leads to children spending comprehensive case planning, and structured prolonged time in foster care. and frequent visitation, parents often struggle to comply with complex court orders. Furthermore, while ASFA mandates more frequent case reviews by the court, the first A parent’s inability to maintain review hearing commonly occurs 6 months after the disposition of a case, leaving the a drug-free lifestyle and make parent very little time to complete the case other significant changes delays plan and comply with court requirements. After the initial hearing in a child maltreatment reunification with his or her case, parents typically leave the courtroom angry at the system for intruding in their children and may ultimately lead to lives, unclear about the court’s expectations, the termination of parental rights. unaware of how to access community services, and unmotivated or unable to follow through.
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The complexity of child abuse and neglect cases and the requirements of ASFA have created a great challenge for family courts, The complexity of child abuse and child welfare systems, and treatment neglect cases and the requirements providers. Representatives from all disciplines within these systems must reevaluate the of ASFA have created a great challenge way in which child abuse and neglect cases are handled, including their approach to for family courts, child welfare systems, supervision and family services. and treatment providers.
FAMILY DEPENDENCY TREATMENT COURTS: FAMILY-FOCUSED PRACTICES child or parent. Using the drug court model, The planning, implementation, and operation FDTC brings these professionals together of a family dependency treatment court is on an interdisciplinary team, which works to not as simple as taking the adult criminal or address the complex array of issues impacting juvenile delinquency drug court model and families-including addiction, child abuse, and placing it in the family court setting. The focus, child neglect. structure, purpose, and scope of a FDTC The expertise of each FDTC team member is differ significantly from the adult criminal critical to the success of families entering the or juvenile delinquency drug court models. system. While team members must adhere to FDTC applies the drug court model to cases individual ethical and professional standards, entering the child welfare system that include they also respect and understand the roles allegations of child abuse or neglect. FDTC of their fellow team members in the FDTC draws on best practices from both the drug process. Ongoing cross training among team court model and dependency court practice members is essential to this interdisciplinary to effectively manage cases within ASFA approach. This exchange of information helps mandates. By doing so, they ensure the best team members gain a better understanding interest of children, while providing every of each other’s roles and how they can work imaginable service to the parent(s). Without together to reduce institutional or programmatic these services, the parent(s) will more than barriers to better serve families. likely lose custody of their children and put future children at risk. FDTC partners include the court, child protective services, and an array of service providers for parents, children, Since an FDTC focuses on cases and families.
Since an FDTC focuses on cases of child abuse of child abuse and neglect that and neglect that involve parental substance involve parental substance abuse, abuse, FDTCs’ goals are to protect children and to reunite families by providing drug-abusing FDTCs’ goals are to protect children parents support, treatment, and access to and to reunite families by providing services. In the more traditional family court system, professionals from child protective drug-abusing parents support, services, treatment providers, and public health systems separately report to the court, treatment, and access to services. making requests that can be inconsistent with each other and ultimately leading to results that may not be in the best interests of the
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for substance-abusing parents. Based on comprehensive assessments, the FDTC team Because the judge focuses treatment develops service and treatment plans that resources on the parent, FDTC improves address the needs of the entire family. In the traditional family court process, child protection outcomes for children and families. case plans and substance abuse treatment plans often are developed in a vacuum, out of touch from other services with which the family is involved. In contrast, the FDTC team The lasting collaborative partnership of an agrees on the needs of the parent and child FDTC team requires strong leadership. Though and determines the pace and order of each the development and ongoing operation of requirement in the case and treatment plans. an FDTC team may be shared among many The team regularly reviews and modifies individuals and systems, the judge is the these plans, as necessary. team’s natural leader in the FDTC process because of the court’s legal responsibility FDTCs also heighten the judicial oversight of to make judgments about the best interests children and families by increasing the number and safety of children. Because the judge of times a parent is required to report before focuses treatment resources on the parent, the court. Weekly or bi-weekly drug court FDTC improves outcomes for children and review sessions are common, and a team families. Parents who abuse substances are meeting typically precedes these court much less likely to effectively provide for sessions. In this pre-court meeting, the team the basic needs of children, often resulting reviews progress in each case to be called in neglect and increasing the likelihood of before the FDTC that day. Team members long-term emotional, intellectual, and physical may recommend modifications to the unified problems for children (National Clearinghouse treatment and case plans. Team members on Child Abuse and Neglect Information, also make recommendations to the judge for 2003). FDTC provides an elaborate support sanctions or incentives to encourage positive network for families to ensure the safety of behavior and discourage noncompliance. To children, while simultaneously assisting the ensure the best use of time and personnel, parent in making significant life changes. the court receives a uniform report in advance of the team meeting. This meeting prepares the judge and team by providing accurate, timely information on each case brought The FDTC review session is a valuable before the court that day. opportunity for the judge to interact The FDTC review session is a valuable oppor- tunity for the judge to interact with each with each parent on a regular basis, parent on a regular basis, providing immediate providing immediate responses responses to compliance and noncompliance with both support and re-direction. The court- to compliance and noncompliance room, traditionally adversarial, is transformed into an opportunity for judges to constructively with both support and re-direction. address problems. In an FDTC, parents are empowered to be involved in decision making and are acknowledged for their accomplish- In an FDTC, child protective services and ments. They also must face their problems treatment providers join forces to identify, and accept the consequences for noncompli- assess, and provide immediate access to ance. Although the participant in FDTC court substance abuse treatment and other services appearances is the parent, the focus of the
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team meeting and court hearing are on the progress and obstacles facing both parents and children. In an FDTC, parents are empowered to
The FDTC team monitors the progress of be involved in decision making and are families and continuously facilitates access acknowledged for their accomplishments. to services through the exchange of informa- tion and coordination across systems. The identification of services in the FDTC extends far beyond substance abuse treatment. FINAL THOUGHTS Abstinence from drugs and alcohol, although FDTCs have enhanced the ability of the family a significant accomplishment for parents court, child protection agencies, and treat- involved in child welfare services, is not the ment systems to respond to families in crisis. only factor that determines whether a child Not only must parents in FDTC take responsi- is reunified with a parent. Issues such as bility for their substance abuse and recovery, domestic violence, mental and physical health, but they must also be held accountable to pending criminal charges, housing, child care, provide their children a safe, stable, drug-free and employment are factors that can delay the home environment. When FDTCs function reunification process and ultimately increase well, their promise is extraordinary. FDTCs the time children remain in out-of-home place- afford substance-abusing parents a genuine ments. By providing greater coordination opportunity for family reunification with sup- and access to services, FDTCs support and port and treatment and strengthen the com- encourage the development of healthy parent- munity response to child abuse and neglect child relationships. by decreasing the risk of physical and emo- tional harm to children. FDTC RESEARCH
Preliminary data from a federal cross-site Meghan M. Wheeler, M.S. is a Project Director for the study to evaluate the effectiveness of FDTC, National Drug Court Institute responsible for training conducted by the Northwest Professional and technical assistance for family dependency treatment courts nationally. Ms. Wheeler can be Consortium, Inc. (2005), indicate positive reached at [email protected] child welfare, court, and treatment results: On average across sites, parents enrolled in family treatment drug courts were more likely than parents in traditional child welfare case processing to be reunified with their children FDTCs have enhanced the ability and less likely to have terminations of parental rights. Furthermore, on average, family treat- of the family court, child protection ment drug court cases were shorter than agencies, and treatment systems traditional child welfare cases. The strongest results were in the treatment arena: family to respond to families in crisis. treatment drug court parents were more likely to enter treatment, had more treatment episodes, spent more total days in treatment, and were more likely to complete treatment than comparison group parents (B. Green, personal communication, January 2, 2005).
These evaluation findings demonstrate the value and benefit of the drug court model to address the intergenerational cycles of substance abuse and child maltreatment.
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References Endnotes Adoption and Safe Families Act of 1997, Pub. L. 1. In this document, the term “Family No. 105-89, 111 Stat. 2115 (1997). Dependency Treatment Court” (FDTC) is used Administration on Children, Youth and Families throughout, although locally an FDTC may be (DHHS). (2006). Child maltreatment 2004. referred to as Family Drug Court, Dependency Washington, DC: U.S. Government Printing Drug Court, Family Treatment Court, and the Office. like. The name Family Dependency Treatment Court was coined during a joint meeting of the Child Welfare League of America. (2001). Alcohol, Office of Justice Programs, Bureau of Justice other drugs, and child welfare. Washington, DC: Assistance, National Council of Juvenile and Author. Family Court Judges, National Association of Center for Substance Abuse Treatment, Bureau Drug Court Professionals, and National Drug of Justice Assistance, & National Drug Court Court Institute to define more specifically the Institute. (2004). Family drug treatment courts: drug court model applied in child abuse and Addressing child abuse and neglect cases neglect case processing. using the drug court model. Washington, DC: 2. In this document, the terms “child maltreat- U.S. Department of Justice. ment” and “child abuse and neglect” are used Huddleston, C.W., Freeman-Wilson, K., & interchangeably. Marlowe, D.B. (2006). Painting the current pic- 3. In this document, the term “Family Court” ture: A national report card on drug courts and is used throughout to refer to the state court, other problem solving courts in the United which has jurisdiction over child abuse and States (Volume II, No. 1). Alexandria, VA: neglect cases. National Drug Court Institute. 4. Permanency planning is defined as a process National Center on Addiction and Substance Abuse through which planned and systematic efforts at Columbia University. (1999). No safe haven: are made to ensure that children are in safe Children of substance-abusing parents. New and nurturing family relationships expected York, NY: Author. to last a lifetime. (See: http://www.cwla.org/ National Clearinghouse on Child Abuse and Neglect newsevents/terms.htm .) Information (DHHS). (2003). Substance abuse and child maltreatment fact sheet. Washington, Publisher DC: Author. C. West Huddleston, III National Clearinghouse on Child Abuse and Neglect Director, National Drug Court Institute Information (DHHS). (2005). Foster care: National Drug Court Institute Numbers and Trends. Washington DC: Author. 4900 Seminary Road, Suite 320 Office of the Federal Register. (2000, January 25). Alexandria, VA 22311 Federal Register 65(16), 4019-4093. 703.575.9400 ext. 13 Worcel, S., Green, B. L., Furrer, C., & Burrus, S.W. 703.575.9402 fax (2005). Family treatment drug court evaluation: [email protected] Year three report. Portland, OR: NPC Research.
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DRUG COURT PRACTITIONER FACT SHEET
FACT SHEET QUIZ: WHAT DID YOU LEARN?
Test your new knowledge. Answer these true and false questions based on the Fact Sheet text.
T F 1. FDTC is integrated in the existing family dependency court structure.
T F 2. The multidisciplinary team exclusively focuses on substance abuse treatment and recovery for parents.
T F 3. FDTC is simply taking the adult criminal or juvenile delinquency drug court model and placing it in a family court setting.
T F 4. The operational structure of the FDTC draws on best practices from both the drug court model and dependency court.
T F 5. A parent’s abstinence from drugs and alcohol is the only factor that determines whether a child is reunified with a parent.
T F 6. The FDTC team monitors the progress of families and
facilitates access to services for parents and children.
1. True; 2. False; 3. False; 4. True; 5. False; 6. True 6. False; 5. True; 4. False; 3. False; 2. True; 1. Answers:
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NATIONAL DRUG COURT INSTITUTE
4900 Seminary Road, Suite 320 Alexandria, VA 22311 (703) 575-9400 1-877-507-3229 (703) 575-9402 Fax www.ndci.org Drug Court Review, Vol. VI, 1 67
AN OVERVIEW OF OPERATIONAL FAMILY DEPENDENCY TREATMENT COURTS By Judge Nicolette M. Pach (ret.)
The intent of this article is to lay the groundwork for a national conversation about Family Dependency Treatment Courts (FDTCs). While FDTCs are in many ways similar to drug courts, they have their own set of complications that render NADCP’s 10 key components necessary, yet insufficient, to guide the establishment, maintenance, and improvement of FDTCs. Questions about best practices surround such issues as child welfare, the Adoption and Safe Families Act (1997) timelines, the civil court arena, and the scope of the intervention. When the best interests of the child are paramount, sanctions and incentives for an alcohol and other drug (AOD)-involved parent must be carefully handled. Federal timelines must be fully considered by FDTCs in their planning. Sanctions in particular are complicated by the fact that FDTCs occur in a civil arena rather than the criminal one like traditional drug courts. Finally, a court must decide whether the FDTC intervention will consider a full range of psychosocial and legal problems facing a particular family, or if it will concentrate solely on AOD involvement. This article should serve as a focal point through which those professionals involved in FDTCs can create their own components necessary for FDTCs.
Nicolette M. Pach, a Judge of the Family Court of the State of New York from 1993 to 2002, presided over New York State’s first Family Treatment Court which opened in 1997. She initiated and oversaw the development of this court, which was designed to address the needs of the children who are neglected as the result of parental substance abuse. Judge Pach is an independent consultant to national organizations. Her expertise lies in helping to develop Family Dependency Treatment Courts and assisting states and localities to address issues concerning the coordination of family courts with child welfare systems and 68 Family Dependency Treatment Courts substance abuse treatment providers. Judge Pach has gained national recognition for her innovative work. In 2000 she received the Howard Levine Award for Excellence in Juvenile Justice and Child Welfare from the New York State Bar Association, and in 2001 she received the Adoption MVP Award from the Dave Thomas Center for Adoption Law in Ohio.
Direct all correspondence to Honorable Nicolette M. Pach (ret.), 6165 Jericho Turnpike, Commack, NY 11725. (631) 462-5950; (631) 462-5029 (fax); [email protected] Drug Court Review, Vol. VI, 1 69
ARTICLE SUMMARIES
ESTABLISHING FDTC BEST PRACTICES COURT CALENDARING [9] While Family PRACTICES Dependency Treatment [12] Some courts sub- Courts can use NADCP’s divide the matters related 10 key components for to specific families, while guidance, they require others maintain a “one their own guiding family/one judge” style principles. practice that enables a single judge to hear all NECESSARY PARTNERS matters related to a family. AND ROLES [10] FDTCs are based on PHASE STRUCTURE AND collaboration between the MANAGEMENT OF courts and various CLIENT BEHAVIOR agencies, including Child [13] While phase Protective Services. advancement is an important incentive, DEFINING THE MISSION contact with the child OF THE FDTC must be conducted with [11] The authoritative the child’s best interest in scope of a specific FDTC mind, not simply as a can range from monitoring court response to the AOD compliance to parent’s behavior. addressing all psychosocial and legal STRUCTURE OF THE problems facing a FDTC particular family. [14] Successful FDTCs tend to have a steering committee, a planning team, and a therapeutic team.
70 Family Dependency Treatment Courts
CASE MANAGEMENT QUESTIONS TO BE [15] There are numerous ANSWERED ways to approach case [16] Ultimately, what management for FDTCs. ought to be the mission of Issues to be addressed FDTCs? How ought include assessment, case FDTCs interface with the planning, linkage to Adoption and Safe services, monitoring, and Families Act? advocacy.
Drug Court Review, Vol. VI, 1 71
INTRODUCTION
ommunities have developed family dependency treatment courts (FDTCs) in response to the C overwhelming increase in the number and complexity of dependency cases involving child abuse and neglect where parental drug or alcohol abuse is a factor. These courts are designed to quickly identify and assess substance-abusing parents; provide immediate access to substance abuse treatment and related services; remove barriers to successful completion of treatment; and provide ongoing judicial supervision and reliable monitoring of parental sobriety. FDTCs use a system of sanctions and incentives to help increase accountability on the part of the parents. By using informed judicial decision making, these specialized courts allow for the safe reunification of families or the finding of alternative permanent homes for children in a timely manner where reunification is not possible (New York State Commission on Drugs and the Courts, 2000). The design of these courts, therefore, requires a coordinated, collaborative approach.
FDTCs are not a new or separate legal entity and they operate within their respective state’s existing legal structure. These courts address social problems associated with parental substance abuse in the legal context of the family court, which has jurisdiction to hear child protective proceedings as set forth in state constitutions or statutes.
FDTCs serve families that are disrupted by parental drug or alcohol abuse in which neglected children must be protected. In child protection proceedings, these family courts focus first on child safety, and then on remediation of the issues that brought the family before the court. The court’s ultimate legal requirement is to assure that children have a safe, stable, and permanent home within a developmentally appropriate time frame.
72 Family Dependency Treatment Courts
[9] FDTCs are modeled structurally after drug courts, which were developed in the late 1980s to focus on adult substance-abusing criminal offenders. By 1997, a consensus was reached among drug court professionals and Defining Drug Courts: The Key Components was published by the National Association of Drug Court Professionals (NADCP, 1997). The key components identified for criminal drug courts are informative for FDTCs but must be reformulated to suit dependency courts, as these courts have considerations well beyond those of the criminal drug courts. The primary focus of the FTDC is the safety and well being of the child. The goal is to maintain the family unit if possible and, if the child must be removed from the parent’s custody, to reunify the family promptly as soon as the parent can safely care for the child. If timely reunification is not possible following reasonable efforts, the court is required to devise an alternative permanent plan for the child. As part of this plan, Child Protective Services (CPS) is required to begin proceedings to terminate parental rights and, if no relatives are available to raise the child, find an appropriate adoptive home. The court must assure that these goals are accomplished in a way that is least harmful and most beneficial to the child.
In the context of developing key components for FDTCs, a discussion of the questions posed by Jane M. Spinak (2002) in her article “Adding Value to Families: The Potential of Model Family Courts,” is warranted. First are the questions that must be addressed in any family court reform effort:
...[T]he breadth of potential authority by a judge fully exercising her discretion within such a structure inevitably raises a question of the scope of the court’s power. This question, which has been at the heart of every effort to create or reform Family Court, has been posed in a variety of ways. (Spinek, 2002, p.336) Drug Court Review, Vol. VI, 1 73
Beyond addressing the scope of the court’s power, additional questions must be asked, including:
• What role is appropriate for the court? • How far should the court go in administering access to services, service delivery, and supervision of those services? • How does each court assure that they actually are adding value to the lives of the families under their care? (Spinek, 2002, p.340) • Does the court take into account established exemplary family court practices, the practices of the Model Courts developed under the auspices of the National Council of Juvenile and Family Court Judges Permanency Planning for Children, and the emerging work of the National Center on Substance Abuse and Child Welfare? (Victims of Child Abuse Project, 1995; Schecter, 2001) • How well does the court meet the Adoption and Safe Families Act’s comprehensive Permanency Planning requirements? • How well do Model Courts assure reasonable efforts are made to identify and assess substance abuse, engage and retain parents in treatment, and assess and address the extraordinary needs of their children?
This paper will describe some of the ways family courts across the country have adapted criminal drug court components and simultaneously developed other features to address and meet the complexities of child protection cases. In addition, common features of existing FDTCs, as well as differences in the ways in which they carry out their basic mission, will be described. The overarching mission of FDTCs is to achieve timely permanency of a stable home life for children in dependency cases where parental substance abuse is a factor, by promptly addressing parental substance abuse issues, and identifying and addressing the children’s needs through a court-based collaboration of agencies to 74 Family Dependency Treatment Courts promote reunification where possible and if necessary, an alternative safe and stable home.
This paper is not intended to assess which are the best practices for a FDTC, but rather to serve as a way to open the discussion among FDTC professionals so they can begin to reach a consensus on the goals, objectives, and operational practices of FDTCs. In addition, this paper will examine how the key components derived from the adult drug courts apply to FDTCs and identify additional attributes that are essential to the mission of FDTCs. Overall, the intent of this paper is to identify issues and raise questions yet to be resolved by the field as FDTCs continue to evolve.
This paper is based on the review of policy and procedure manuals from fourteen operational FDTCs across the country (see Appendix B when referenced) as well as on observations of FDTCs in several states. It also is informed by the author’s experience participating in the creation of the Suffolk County, New York Family Treatment Court and presiding over that court for five years.
BACKGROUND
Parental Substance Abuse in Child Abuse and Neglect Cases
In the last decade, family courts have experienced a large increase in child protection cases, an increase that appears to be driven by the co-occurrence of parental substance abuse and neglect case filings. Experts estimate that in 40 to 80 percent of confirmed child abuse and neglect cases, parental substance abuse is a factor (Child Welfare League of America, 2001). Consequently:
[Family courts] have suffered serious strain from a vast expansion in the number of drug-related filings in recent years. Such Drug Court Review, Vol. VI, 1 75
cases typically involve allegations of parental abuse and neglect of children, where there is an indication that the abuse and neglect stems from a parent’s drug addiction. Such cases often result in the removal of children from their homes, and the effects…on children and families—and, eventually, society at large—is severe. The high cost of foster care ensures that such cases are extremely expensive, too. (New York State Commission on Drugs and the Courts, 2000, section III)
Permanency Planning in the Best Interest of Children
In 1997, coinciding with the rise in substance abuse driven child neglect cases, Congress passed the Adoption and Safe Families Act (ASFA). This has greatly affected family court practices and must be factored into any consideration of attributes essential for FDTCs. At that time, growing numbers of children, neglected by their parents, were lingering in foster care after initial court intervention to assess and address immediate child safety concerns. They were being raised by “the system” instead of by families in safe, stable, and permanent homes. ASFA was intended to remedy that situation by requiring timely permanency.
Specifically, ASFA requires the courts and the child welfare system to resolve dependency cases by implementing a plan for permanency in a timely fashion. In keeping with children’s developmental needs, this legislation imposed strict time limits within which the court was to establish permanent, safe, and stable homes for children who are the subject of a dependency case. ASFA time frames are significantly shorter than the usual time it takes, under the best of circumstances, for an addicted parent to establish a sober, stable lifestyle (Young, Gardner, & Dennis, 1998, p. 20). However, while the impact on family court proceedings 76 Family Dependency Treatment Courts has been great, legally, ASFA “…is merely an attempt to refine the law concerning permanency planning for children in foster care so that [the] law more fully and expeditiously accomplishes its pre existing goals.” (In re Marino S., 1999/2002/2003)
ASFA requires the court to hold a “permanency hearing” to approve or modify the permanent plan proposed by CPS for a family within 12 months of the finding of neglect, or within 14 months of the child’s removal, whichever is the earlier, although some states have enacted even stricter time frames. The preferred permanent plan is a safe and stable home with the child’s natural parent. But there are provisions requiring that a petition to terminate parental rights (TPR) be filed if the parent is not ready for reunification with a child who has been in foster care 15 out of the last 22 months.
In addition, ASFA has expanded the role of the courts. The courts must judge the sufficiency of the efforts made by CPS to assist families at several key junctures. ASFA requires CPS to make “reasonable efforts” to prevent the removal of children in the first instance and to reunify families where children have been removed. There are financial consequences to states, in the form of the loss of federal funds for foster care, if they do not meet ASFA requirements. The court also is placed in the unfamiliar position of judging the CPS case plan and developing its own alternative case plan if the CPS plan is not deemed adequate.
All of these requirements are in addition to the court’s pre existing duty to hear the evidence, determine if there is enough evidence to establish a case, and assure due process for the parents, children, and families (Spinak, 2002, p. 331). It is also the responsibility of the court to assure the safety and due process of children and their families by “ensur[ing that] reasonable efforts were made to assist the family in remaining a unit and remaining free of unnecessary Drug Court Review, Vol. VI, 1 77 state intervention.” (Spinak, p. 341) Accordingly, the strict ASFA time frames create additional strain on already overburdened family courts.
ASFA has, however, provided an additional impetus for communities to develop FDTCs. Under ASFA, all states must conduct their own statewide self-assessment of child and family services and then submit to a Child and Family Service Review conducted by the federal government. Included in the Review are assessments of outcomes concerning child safety, well-being, and permanency. Findings concerning systemic factors in need of improvement are included in the state’s proposed Program Improvement Plan, which must gain federal approval in order for the state to continue to receive certain federal funding. Federal findings, particularly those concerning deficiencies in the array of services, often could be addressed by establishing a FDTC.
FDTCs can be structured to help jurisdictions operate within the ASFA time frames. These courts can aid community interagency collaboration by providing sufficient services constituting “reasonable efforts” to assist families in reunification. FDTCs can assure due process, timely case processing, and permanency hearings. The frequent judicial and case management monitoring yields a clear record of a parent’s progress toward providing a safe and stable home, and of CPS’s efforts to assist the family with reunification. Most importantly, FDTCs can improve outcomes for children and families by providing a motivated parent with optimal opportunity to establish a stable recovery in time to regain custody of his or her child.
NECESSARY PARTNERS AND ROLES
[10] The complexities within child welfare agencies and substance abuse treatment agencies, coupled with the different perspectives and 78 Family Dependency Treatment Courts
world views, make cooperation between service systems difficult to establish and harder to maintain. But now more than ever, collaboration between these agencies is essential if families are to be given real opportunities for recovery and children are to have the chance to grow up in healthy family situations. (Department of Health and Human Services, 1999)
FDTCs bring together various community agencies and professionals who work with child welfare cases as a team to develop a unified plan. The commitment and participation of community stakeholders is integral to the success of FDTCs. Stakeholders include the court, CPS, alcohol and other drug agencies, substance abuse treatment providers, and the attorneys representing the family and CPS, as well as the families themselves. Some FDTCs also include ancillary service providers such as mental health services, the public health nurse, providers of early childhood intervention services, and domestic violence services. Of the fourteen courts reviewed for this paper, all included, at a minimum, a judge willing to take on a leadership role, CPS representatives, treatment providers, a representative of court administration, and a court coordinator. Coordinator is a particularly important role, as he or she manages court operations and effectuates the changes FDTCs make in court calendaring practice, including the accommodation of more frequent court appearances and staff meetings within the courthouse. Finally, information management experts are frequently included to assist in the effective monitoring of cases, sharing of information, and collection of data sufficient to evaluate the program. By establishing these interdisciplinary teams, FDTCs facilitate access to all of the services that are necessary to reunite families.
The support of the agency responsible for child protective services is particularly critical to the success of the FDTC. CPS has the obligation to investigate cases of child Drug Court Review, Vol. VI, 1 79 neglect and abuse, assure child safety, and determine if court intervention will be sought to ensure the cooperation of the parents. The operation of CPS has been greatly impacted by the passage of ASFA, and some FDTCs are planned and operated in a way that assists CPS in meeting the demands of ASFA. For example, the FDTCs surveyed for this paper assist CPS in “making reasonable efforts” to engage and retain parents in substance abuse treatment.
Of course, for a FDTC to be successful, appropriate substance abuse treatment services must be available. Treatment providers and/or the local governmental agency responsible for overseeing the contracts and/or licensing of treatment providers must participate in the planning and support of the FDTC. In localities where treatment is relatively plentiful and many providers have clients who are participants in the FDTC, the local governmental agency with authority to license or contract with treatment providers can help to negotiate provider participation agreements. In other jurisdictions with only one or two treatment providers, the providers themselves participate directly in the collaboration. The inclusion of treatment providers in the planning process also enables these providers to bring information to the table regarding funding options and opportunities, as well as to help assess appropriate treatment needs for individual clients and available resources in the community to meet those needs.
FDTC coordination occurs at both the administrative and operational levels, which avoids the duplication of efforts. Coordinators are employed by various participating agencies or directly by the court system. Policy makers and team members come from many agencies and each answers to their own chain of command, which poses an inherent challenge to coordination. On an operational level, it is essential to coordinate the work of all the participating agencies; assure that quality information is communicated to the court and CPS; and keep a consistent presentation to 80 Family Dependency Treatment Courts participants and families. If a court is not well coordinated on an operational level, the participants inevitably play one team member, including the judge, against the other. This enables the participant to continue his or her addictive behaviors. FDTCs, like adult drug courts, attempt to minimize the adversarial nature of court proceedings, and try to avoid enabling participants to continue the manipulative behavior that is characteristic of substance abusers.
Suffolk County, for example, has broken the coordination function into two parts. The Director, a court employee with guidance from the administrative oversight team, is responsible for administering, coordinating, developing, and implementing policy. She also maintains interagency relationships by organizing cross training events between CPS, treatment providers, and other FDTC staff as a way to enhance and develop the array of services available.
On an operational level, the Clinical Coordinator, also an employee of the court system, is responsible for coordination and collaboration on individual cases. She convenes the team members for staffings before each court appearance and assures that the reports sent to the judge are complete. She is also responsible for presiding over quarterly comprehensive case review meetings for each family with all providers and team members requested to participate. This is in addition to the statutorily mandated case planning that is required of CPS. The Clinical Coordinator invites all service providers and the CPS worker to join the operational team members at this meeting. Progress on service plan goals is assessed as well as client progress through the phases of the FDTC. Written reports of these meetings are submitted to the judge and all attorneys.
Since the operating FDTC requires communication within a multidisciplinary group, an effective means of information sharing must be developed. Ideally, this calls for the ongoing participation of information management experts Drug Court Review, Vol. VI, 1 81 from the earliest possible point in the creation of the FDTC. Since FDTCs have not yet been systematically evaluated, the team member with management information expertise must incorporate evaluation issues into the planning of the court from the ground up. However, should the appropriate technology not be available, FDTCs must maintain records in written case files, phone call logs, and staff meeting minutes.
DEFINING THE MISSION OF THE FDTC
[11] The court’s definition of its mission may impact its design. The mission may be narrowly drawn to provide prompt access to treatment services and judicial monitoring of abstinence for a particular family member. Alternatively, the mission may be broadly defined to address all the needs of the family. Some FDTCs are intimately involved in the delivery of child welfare services, while others have opted not to become involved with providing direct services and simply provide close judicial monitoring of compliance with services ordered and offered in the community.
The CPS intervention begins upon receipt by child welfare officials of a report of child abuse or neglect. In some communities, collaborative systems are available to access substance abuse treatment in child welfare cases at the inception of CPS intervention well before court intervention is contemplated. In other communities, the FDTC is the first opportunity for clients to participate in a structured protocol to access substance abuse services.
In light of these various issues, jurisdictions that create a FDTC must examine the role of the FDTC judge. In particular, it must be determined:
Whether the role of the Family Court judge is primarily adjudicative or administrative: is her primary purpose to decide specific disputes or to manage the larger, more complex issues that the 82 Family Dependency Treatment Courts
family brings with it to the courthouse? ...[I]f the court is assuming the larger, managerial role, is that role primarily preventive or primarily remedial? That issue leads to two collateral questions. First, should the court subsume some or all of the services provided directly under its control, or should it maintain the traditional division between the executive and judicial functions? Second, if the judge does assume a broader role, does this necessarily include a leadership role for the court in the larger community it serves? (Spinak, 2002, p. 336)
Additionally, in some jurisdictions, family courts administer services for litigants such as probation and mediation. In other states, courts have not traditionally provided services directly and have served only the adjudicative function. San Diego County, CA, engaged in comprehensive community systemic reform to facilitate access to and delivery of substance abuse treatment services called the Substance Abuse Recovery Management System (SARMS). Long before court intervention, at the initiation of a child protective case, SARMS assists CPS workers in assessing whether substance abuse is present; coordinates a substance abuse assessment; and provides parents with immediate access to substance abuse treatment. The SARMS model is designed to winnow out the more compliant parents giving them an early and effective opportunity to address substance abuse, thus permitting them to avoid court. The assessment, referral, and case management are conducted in the community rather than the courthouse. San Diego has a multi-tiered and increasingly intensive continuum of intervention culminating in referral to the FDTC (locally known as the Dependency Court Recovery Project) if the parent has not responded to earlier SARMS intervention (Milliken, 2001). The FDTC is the strongest measure available to induce parental cooperation (Young & Gardner, 2002). Court resources therefore are reserved for the most difficult cases. Suffolk County, on the other hand, did not Drug Court Review, Vol. VI, 1 83 develop formal pre-court protocol to access treatment services already in place. Thus, facilitated access to treatment along with coordinated case management becomes available only after the parent has been brought to court.
EXERCISING LEGAL JURISDICTION AND INTAKE
Civil and Criminal Jurisdiction
FDTCs are limited by the jurisdiction conferred on them in their own states. Some FDTCs may be empowered to hear both dependency cases and criminal cases, while others will be limited to dependency cases only. This, therefore, impacts the design of the FDTC. In New York State, for example, dependency matters and criminal matters are handled in separate courts. New York FDTCs cannot entertain related or unrelated criminal matters. While the family court judge and the judge presiding over the criminal matters may become aware of the other proceedings, there is no formal mechanism that would allow a single judge to preside over both cases.
In Jackson County, Missouri, the judicial officer who presides over the dependency case has limited criminal jurisdiction and may preside over certain aspects of related criminal charges of child endangerment. The court also may take jurisdiction when the parent is eligible for criminal drug court on an unrelated criminal matter and has a child who is the subject of a dependency proceeding in the family court. This design necessitated the development of protocols with law enforcement, the prosecutor, and the criminal court so that appropriate cases can be transferred to and from the family drug court. In the event of parental failure, the criminal case is returned to criminal court for further proceedings. Conversely, in Washoe County, Nevada, the court exercises both civil and criminal jurisdictions in admitting parents to FDTC. Parents may come to the court’s attention due to criminal activity or the removal of children 84 Family Dependency Treatment Courts by CPS. Referrals typically come from CPS or other treatment providers and non-CPS cases may be referred and may be accepted upon approval by the team.
WHEN TO TAKE JURISDICTION: TIMING OF FDTC INTERVENTION
In the jurisdictions reviewed, FDTC intervention is sought at differing points along the continuum of the dependency case court process. When structuring the timing of admission of a family’s case into FDTC, courts must be mindful of the ASFA requirements. Since the purpose of FDTCs is to promote the safe reunification of families, parents must be admitted to FDTC with enough time remaining to beat the ASFA clock (Victims of Child Abuse Project, 1995; Schecter, 2001).
Admission to FDTC can be as early as the parent’s arraignment with a conditional enrollment at an uncontested adjudication. Enrollment also may occur further on in the process, at the disposition proceeding, when the order reflecting the service plan for the case is issued. Another option is to offer enrollment in FDTC after a finding that the parent is in contempt when the parent has been noncompliant with court-ordered treatment services or has not remained abstinent. Identification of the target population and eligibility criteria impacts the timing of admission as well. A focus on newborns, for instance, requires admission early in the dependency case, while a focus on repeated treatment failures by parents results in later admission to the court process.
Early enrollment in FDTC occurs in Kansas City, Missouri, where most cases are referred at the initiation of the court process through the Newborn Crisis program. Babies born with positive drug screens and their parent(s) are referred for acceptance in the FDTC immediately so the Drug Court Review, Vol. VI, 1 85 mothers can be promptly enrolled in treatment and separation of mother and child can be avoided.
In Mecklenburg County, North Carolina, parents have the option of being admitted to the FDTC early in the court process if they acknowledge substance abuse problems. However, they have further opportunities for later enrollment in the FDTC and may elect to participate after a petition has been filed, and the court has made a formal finding of willful contempt of court. A jail sentence is imposed but suspended on the condition that the parent enter the FDTC within 24 hours.
COURT CALENDARING PRACTICES
[12] Family courts differ in their calendaring practices. In some jurisdictions where there are multiple judges sitting in the family court, judges specialize in certain types or aspects of cases. For instance, one judge may hear juvenile delinquency cases while another judge may hear dependency cases. Dependency cases may be further divided into sub categories, with one judge hearing emergency removal (or shelter care) hearings and then a different judge conducting the adjudication (fact finding) and disposition. Yet another judge may preside over the permanency hearing and another over the termination of parental rights.
Model Court practice, as developed by the National Council of Juvenile and Family Court Judges, recommends “direct calendaring” practice. That is, courts that observe “one-family/one-judge” (Victims of Child Abuse Project, 1995, p. 19) take jurisdiction over the entire dependency case, from referral (usually at the initial “shelter” hearing) through adjudication, disposition, permanency hearing, and finally through reunification or TPR.
Court calendaring practices in FDTCs vary as well. Some FDTC judges preside over the entire family’s case, 86 Family Dependency Treatment Courts overseeing both the dependency case and monitoring the parents’ compliance with child welfare case planning, abstinence, and treatment. In other courts, the practice is to leave the dependency case and the monitoring of the children’s issues in the “home court” with one judge, while referring monitoring of the parent’s abstinence and treatment compliance to a second “drug court” judge. The choice of design may be a reflection of any of several reasons, including strongly held judicial philosophy, the level of pre- existing cooperation across the court, child welfare and drug treatment systems, and the availability of judicial and community resources to assist the families.
Using the one-family/one-judge model, a FDTC judge monitors the parent’s compliance with court-ordered substance abuse treatment and progress in recovery. The same judge is also responsible for assuring that the child’s need for timely permanency and ancillary services are met. The court uses the parents’ desire for reunification to leverage compliance with treatment and to encourage the parent to maintain abstinence. The FDTCs in Miami/Dade County, Kansas City, Billings, and Suffolk County are examples of one-family/one-judge calendaring practice.
In other jurisdictions, the original dependency action is handled by one home court judge from inception through reunification, or TPR and adoption, while a second judge presiding over the drug court monitors only the parents’ compliance with the portion of the court order requiring abstinence and substance abuse treatment. The focus is on parental sobriety with speedy intervention, assessment, referral to substance abuse treatment, and frequent judicial monitoring of a parent’s progress in recovery. The dependency judge will receive evidence of the parent’s compliance with substance abuse treatment during drug court participation in the dependency proceedings.
Drug Court Review, Vol. VI, 1 87
In Durham County, the decision to have one judge for the FDTC and a second judge preside over the dependency case was deliberate (P. Baker & A. Stith, personal communication, June 10, 2003). The Presiding Judge was cognizant of the fact that FDTC judges receive a wealth of information during staffings and at FDTC appearances, and that unsuccessful FDTC cases may result in TPR. Decisions at a TPR proceeding must be based solely on evidence presented at the TPR proceeding itself. In this jurisdiction, one judge presides over the entire dependency case (from inception through TPR), while another judge oversees compliance with alcohol and other drug (AOD) treatment and abstinence. This particular model was designed to avoid the appearance that the TPR outcome was influenced by the information presented at the FDTC reviews (Baker & Stith). However, this does not mean that the FDTC judge is blind to Permanency Planning and ASFA issues; in fact, she discusses them with participants as part of drug court reviews. The judge in the dependency case is kept apprised of the parents’ progress by receiving copies of the bi-weekly reports on participants in the FDTC (Baker & Stith).
PHASE STRUCTURE AND MANAGEMENT OF CLIENT BEHAVIOR
[13] The surveyed FDTCs delineate program phases as a means of measuring participant progress and providing guidance to parents in meeting both treatment and service plan goals. There are usually three to four phases with stated goals and requirements for advancement and completion or graduation. Passage from phase to phase is rewarded with tokens of advancement. In some FDTCs, the court responds to both the participant’s progress toward abstinence and also toward establishing a lifestyle that is consistent with providing a safe, stable, and permanent home for their children. In these courts, phase advancement is tied to both 88 Family Dependency Treatment Courts abstinence and compliance with a comprehensive service plan. In other courts, the phase requirements are limited to monitoring parents’ sobriety and addressing issues with their children, with parental contact with children remaining the province of the dependency home court judge.
The initial phase includes the process of assessment, service planning, and admission to treatment and other services. Next, there is a period of commencing services, meeting parental responsibilities within the limits of the court order, maintaining abstinence, and receiving education. This is followed by a period of practicing sobriety skills, obtaining other life skills, taking increased responsibility for meeting children’s needs, and sustaining a sober lifestyle. Finally, there is a period of solidifying gains and accomplishing concrete goals so that children and families may be reunited. Ultimately, following a period of aftercare, child protective and court supervision may be safely removed. The final phase in FDTC requires close monitoring since it is at that point children’s safety is primarily in the hands of their parents and is at great risk if parents are unable to maintain sobriety.
FDTCs have developed systems of responses consisting of incentives and sanctions. These are developed in the context of due process, limits on jurisdiction, substance abuse treatment protocols, judicial philosophy, local culture, and the best interest of the child. These responses range from judicial praise or reprimand, incarceration, reunification with children, and termination of parental rights.
The language used in court reflects the goal of family reunification and consciousness of the fact that FDTC is a civil proceeding, rather than a criminal one. The court wants to give parents the “incentive” to take the steps necessary to be able to safely care for their children. There are “consequences,” favorable and unfavorable, of a parent’s compliance and of a child’s condition. When there is a Drug Court Review, Vol. VI, 1 89 relapse, the court may not wish to “punish” a parent, since substance abuse is a disease of which relapse is a predictable part; the court may choose to “respond” therefore, not with a punishment, but rather, by requiring an increase in the intensity of treatment level.
Contact with children, while some times termed a “reward,” is determined on the basis of the child’s safety and best interest. The parent’s progress, or lack thereof, will have an impact on this decision, but is not the only consideration. For instance, if a child can safely visit with a parent who can behave appropriately during the visit, the parent’s unexcused absence from treatment should not impact on the children’s right to visit with their parent. On the other hand, some children have been hurt by their parent’s behavior when the parent was abusing substances to such an extent that they may not be in a condition to visit a parent, even if the parent is maintaining sobriety. Again, the interest of the child must govern this decision. Successful completion of treatment is not a guarantee of return of custody. The focus of the system of sanctions and incentives is on the child’s safety, best interest, and permanency, not on punishing the parent.
Westchester County’s family treatment court has a fairly typical practice of using incentives and sanctions, with progress acknowledged by the judge in open court. The importance of this as an incentive is sometimes underrated. Parents who find themselves in dependency proceedings often have had conflicted relationships with, and have not received a great deal of praise from, authority figures throughout their lives. The importance of praise from a person with as much authority and power over the respondent as the judge is significant.
Other rewards include hearing the case early in the docket and excusing the parents from the remainder of the FDTC proceeding, or a reduction in the frequency of required court appearances. As a response to the parent’s progress, the 90 Family Dependency Treatment Courts court anticipates an increase in contact or visitation with the child. In Kansas City, for example, tangible rewards, such as $10 vouchers from local stores, are awarded for every 30 days of abstinence. Participants eagerly anticipate the days they are due for a voucher, as they use them to purchase household necessities or treats. Some individuals “bank” their vouchers to purchase needed items when they are ready to establish a household. Generally speaking, FDTCs have become innovative in inventing incentives to encourage responsible behavior and discourage violations of court orders.
Securing participant compliance is a critical issue in criminal and family drug courts. There are times when the punitive connotation of a “sanction” is warranted—for instance, when a parent tampers with a urine sample or lies to the court. Sanctions, therefore, do have a place in FDTC. Kansas City’s policy and procedure manual describes sanctions that include a reprimand from the bench in open court for a first noncompliance. For a second violation, the participant may be required to increase treatment activity, watch a specific educational video, write a report to the court, or write a letter to their children if they missed a visit (which is reviewed by a therapist). In lieu of a report, the parent may be required to create a work of art to express their emotions, participate in community service, sit in court for an entire day, return to a previous phase. A third violation could result in the above sanctions, but also may result in home detention/electronic monitoring or brief incarcerations. Some family courts have the authority to issue bench warrants as a means of assuring attendance at court proceedings and use it to secure parental compliance.
Many FDTCs also have the capacity to incarcerate for civil or criminal contempt. Those FDTCs with criminal jurisdiction can impose sentences of incarceration for criminal offenses. In the criminal court, the use of incarceration as a sanction is clearly acceptable. One of the Drug Court Review, Vol. VI, 1 91 motivations for participation is the avoidance of jail by the defendant. The client contract clearly stipulates that failure to comply can result in incarceration.
In family courts, the motivating factor is the parent’s desire to maintain or regain custody of his or her child. Using the power of a contempt proceeding to incarcerate a parent in a dependency case is a controversial philosophical decision. However, jail is not an anticipated outcome of the usual dependency case. The anticipated consequence of failure to comply with an order in a dependency case is the curtailment or loss of parental rights, not the loss of personal liberty.
While some FDTCs have concurrent criminal jurisdiction, most do not. Many family courts, however, may exercise contempt powers to secure compliance with court orders. Thus, it is technically possible to incarcerate a parent for failure to comply with a court order to attend substance abuse treatment and remain abstinent. In the civil court context, a jail sentence for contempt is designed to secure obedience to a court order. In using this power, the courts take stock of whether the use of incarceration is reasonably calculated to do that. If it appears that the parent’s compliance will not be forthcoming in a time frame where reunification is still possible under ASFA, then often the time for incarceration has past. The court must then turn its focus to an alternate permanent plan for the child.
In the Mecklenburg County Family Treatment Court, the use of incarceration is available. If the parent fails to participate in the court ordered substance abuse assessment, or fails to enter the substance abuse treatment as recommended, an order to show cause why the parent should not be held in contempt may be filed. Upon a finding of contempt, the parent may be incarcerated. There is a schedule of sentences from 24 hours up to 30 days of incarceration. The parent may avoid incarceration by 92 Family Dependency Treatment Courts agreeing to enter FDTC in exchange for a suspension of the jail sentence.
STRUCTURE OF FDTC
[14] In reviewing 14 FDTCs, it was found that three groups of players emerge as part of the court development process: a steering committee, a planning team which often evolves into an ongoing administrative oversight team, and the operational or “therapeutic” FDTC team. Some steering and planning/administrative committees had overlapping or identical memberships. Committee/team composition varied from jurisdiction to jurisdiction based on the range of legal and social issues each court needed to address, as well as the extent to which local law enforcement and social service providers were available and willing to participate in the collaborative effort that FDTCs require.
Generally, agency directors or high level administrators who participate on the steering committee provide the leadership and authority for their organization to engage in FDTC planning and operations (NADCP, 1997). They determine what resources are available to the FDTC, and whether a reconfiguration of existing services, new funding, or collaborative agreements are required, and how those should be secured. Some steering committees agree on core values and principals underlying the creation of the FDTC before engaging in concrete planning activities.
The planning/administrative oversight team usually comprises representatives of the same agencies that participate in the steering committee. They oversee the development and implementation of policy and procedures as the FDTCs become operational. They try to resolve those agency conflicts that inevitably arise. To do this, the representatives need sufficient authority and experience to approve policy and procedures as well as authority over others in their agency who will eventually work on the Drug Court Review, Vol. VI, 1 93 operational team. The planning/administrative oversight committees meet either regularly or as the needs of their FDTC dictate (NADCP, 1997).
The operational FDTC team consists of the individuals who perform the day-to-day tasks of the FDTC. Operational team members perform case management functions; depending on the breadth of the FDTCs mission, case management functions can be expanded. This team uses a non-adversarial collaborative approach to coordinate the identification, engagement, and retention of substance- abusing parents in a variety of services (NADCP, 1997). It includes, at a minimum, the judge, CPS representatives, attorneys for all parties, members with substance abuse expertise, and someone to perform appropriate case management functions. FDTCs differ in the extent to which other agencies are included on the operational team. This is partly determined by how broadly or narrowly the FDTC has defined its mission. In the overall dependency case, parents must participate not only in a substance abuse treatment plan, but also in a broader case plan in an attempt to maintain or regain custody of their children.
A variety of agencies may participate in a FDTC to reach beyond parental sobriety and holistically encompass all aspects of the family’s functioning. For instance, if early childhood developmental issues are included in the FDTC’s mandate, then the participation of the community agency responsible for those services will participate. With the high incidence of trauma issues and domestic violence among the participant population (up to 80 percent of participants), agencies that address domestic violence and victim assistance often are included. Due to the co-occurrence of criminal activity and arrests with substance abuse, cooperation from the probation department and law enforcement also may be sought.
94 Family Dependency Treatment Courts
CASE MANAGEMENT
[15] A significant feature of FDTCs is case management, which includes the following (Siegal, 1998):
• Assessment • Case planning • Linkage to services • Monitoring of participants, families, and case plans • Advocacy
FDTCs have been creative in finding personnel to provide case management under such structural limitations as funding, court design, and pre-existing agency relationships. In some courts, case management oversight is limited to parental participation in treatment, while in others, it includes service planning for families and children and a broad array of services including housing aid, vocational, educational, and employment planning, and various services to address the children’s specific needs. A single team member assigned to work with a single family may perform case management functions, or functions may be shared among various team members.
Credentials for case management also vary. In some FDTCs, case managers are required to have drug and alcohol counseling credentials, but in other courts they are not. In Miami, for example, there are four case managers, called Dependency Drug Court (DDC) Specialists. Their credentials are commensurate with their comprehensive duties. Three of them have master’s degrees and the other has a bachelor’s degree. They are responsible for:
Alcohol and drug abuse screening and assessments, referrals to and enrollment in treatment services, alcohol and other drug testing, progress monitoring, crisis and therapeutic intervention, to engage and retain the Drug Court Review, Vol. VI, 1 95
parent in the dependency court process, advocating for the parent, and keeping the parent motivated to treatment and recovery throughout the long DDC process. Specialists report to the court…on treatment progress, health issues, housing issues, employment issues, and dependent children’s issues. DDC Specialists collaborate with Division of Children and Families (DCF) counselors to develop the substance abuse screening/evaluation/treatment and aftercare portion of the Children and Families Case plan…review the plan with the parents and their attorney’s…staff cases weekly with other team members including DCF counselors, representatives from the Linda Ray Intervention Center, and the nurse practitioner. (Juvenile Court 11th Judicial Circuit, Miami- Dade County, FL, Policy and Procedure Manual, p. 9. See Appendix B)
Given the breadth of their responsibilities, they also are provided with professional weekly clinical supervision and therapeutic training from the University of Miami Department of Psychiatry and Behavioral Sciences.
ASSESSMENT
All FDTCs require a substance abuse assessment of the participating parent to determine the appropriate level of treatment and to establish treatment goals. Courts often make use of existing resources in arranging for substance abuse assessments. Suffolk County was able to outsource a psychiatric social worker from the health department to conduct assessments at the courthouse. The social worker then referred participants to local treatment providers. Other courts depend on treatment providers to conduct assessments. Child welfare, mental health, and other assessments also are conducted by FDTCs, depending on the breadth of their missions. 96 Family Dependency Treatment Courts
Comprehensive assessments of the family, parents, and children are important to assure that the problems that brought the family into the FDTC are addressed. Rarely is substance abuse the only problem facing these families:
Children of substance abusing parents generally, and children in foster care particularly, possess, almost by definition, many of the risk factors and few of the protective factors associated with a host of negative outcomes. For instance, children exposed to severe substance abuse in the home often experience mental, emotional, and developmental problems, as well as severe trauma, which may result from physical or sexual abuse or chronic neglect. (Department of Health and Human Services, 1999)
In addition,
Usually parents who abuse alcohol and drugs and maltreat their children suffer many problems at once. They tend to be socially isolated, to live chaotic lives, to suffer from depression and other chronic health problems, to be struggling with drained financial resources, and to be unemployed. (National Center on Addiction and Substance Abuse at Columbia University, 1999, p. 14).
The Yellowstone County Family Drug Court utilizes a lengthy neurological/psychosocial evaluation of both parents and children being served by the Family Drug Court to identify the multiplicity of issues facing the family. This 8 to 9 hour evaluation, performed by a doctor, is completed during Phase 1 of FDTC participation and is repeated every 90 days. Staff and parents are afforded a comprehensive view of the issues to be addressed. The completed evaluation informs service planning and intervallic administration allows participants and staff to assess progress on an regular basis. Drug Court Review, Vol. VI, 1 97
It also is used to identify needed services, and has been provided to parents who, accompanied by their Child and Family Services (CFS) social worker, are requesting services for their children in the local school district.
Such an extensive assessment is usually not available in other jurisdictions. Most FDTCs use a standard instrument for initial substance abuse screening, such as the Addiction Severity Index, administered by substance abuse counselors either at the courthouse or at the treatment facility to determine appropriate treatment levels. Other assessments are obtained through community resources, such as developmental screens of children conducted by public health nurses.
CASE PLANNING
In dependency cases where parental substance abuse is a factor, multiple case plans may be developed. For instance, treatment providers are required to have a treatment plan for the substance abusing parent, while CPS has statutory responsibility to develop a comprehensive service plan for each case to assure child safety and well being and to promote the reunification of families. Service plans must be developed to assist parents to gain the skills necessary to meet the needs of their children, and these plans must meet the child’s needs, such as developmental delays and physical and mental health problems and may be developed by the service provider or an independent diagnostic assessment agency.
Where the FDTC has jurisdiction over the dependency case, all developed plans come under court scrutiny. Dependency courts have the responsibility under ASFA to initially rule on the sufficiency of the original service plan and, subsequently, whether reasonable efforts have been made to carry it out. The court reviews and approves or modifies permanency plans several times over 98 Family Dependency Treatment Courts the life of a case. These multiple service-planning efforts are enhanced by coordination in the FDTC process.
Communities differ to the extent that parents or family members are included in developing the case and service plan. As an example of inclusion, in Yellowstone County, the FDTC coordinator, treatment provider, CFS worker, and client sit down at regular intervals for “roadmapping” sessions to review progress toward long and short-term goals and to make adjustments in the plan and goals as necessary. A roadmap may address substance abuse treatment, physical and medical concerns, mental health treatment, and parenting issues, as well as meeting lifestyle issues such as housing, employment, and outstanding criminal matters. The initial roadmap, which follows the CFS plan, is completed shortly after acceptance into FDTC, and the parents sign off on the plan. The Yellowstone court finds client participation essential as it invests in them by providing treatment, while getting feedback from parents as to their needs, requests, concerns, and priorities.
LINKAGES TO SERVICES
Some of the FDTCs surveyed have sought or developed resources to address the full range of issues which impact families where children have been abused or neglected as a result of parental substance abuse. These families require an array of services such as physical and mental health treatment of the entire family, parenting skills instruction, early childhood intervention to address developmental delays, and services to assist in ameliorating co-occurring issues such as domestic violence and trauma history.
The Miami/Dade County Dependency Drug Court assures that their families have access to comprehensive services by reaching out into the community to preexisting organizations willing to work closely with the court and tailor Drug Court Review, Vol. VI, 1 99 their programs to meet the families’ needs. Additionally, by developing a strong relationship with the University of Miami, the court has secured additional services. As an example, The Linda Ray Intervention Center associated with the University, provides developmental assessments for children. The Center also provides services for the younger children, at the Center or at home, and moves the children on to Head Start when the children graduate from the Center. The Center offers FDTC parents innovative parenting skills curricula that are scientifically based and use pre- and post- testing to evaluate progress. Additionally, at the Center, under the auspices of the University of Miami School of Nursing, the FDTC operates a health clinic. Parents are referred to the clinic upon entering the court and referrals are made for the full range of health services including family planning. The Center’s services are court ordered and their staff participates in the court process by attending hearings and offering written reports.
MONITORING
FDTCs become involved in monitoring parents’ participation in planned services to the same extent that they are exercising jurisdiction over the matter. Where the FDTC has taken jurisdiction over only substance abuse treatment and abstinence issues, its efforts are limited to monitoring these issues. Where the court has taken a more holistic approach, monitoring occurs across many more domains.
Frequent judicial monitoring of participants was a central feature of every FDTC reviewed. Parents appeared in court regularly and the judge reviewed their progress with them in open court. The judges develop a rapport with the participants and are an integral part of the participant’s support system. Participants must account for their behavior directly to the judge. To keep the judge and child protective services well informed of the participant’s progress, there is additional monitoring outside the court session. 100 Family Dependency Treatment Courts
There is a great variety among FDTCs as to who monitors service and compliance. Some FDTCs rely directly on treatment and service providers, child protective workers, and probation officers dedicated to the FDTC to amass and report information. In others, independent case managers track client’s progress. Some FDTCs have personnel to monitor whether children’s need and service requirements are being met. Case monitoring conducted by an entity independent of the service or treatment provider may enhance system accountability and relieves the service provider of the burden of preparing for court appearances, staffings, and reports. While relying directly on providers for information may reduce the number of personnel necessary to run the treatment court, it also reduces the number of personnel able to provide first hand reports.
In Suffolk County, case management functions are distributed among several participating agencies. A local not- for-profit agency employs drug and alcohol case managers and court-appointed special advocate case managers. The drug and alcohol case managers monitor compliance with substance abuse treatment, perform drug testing at the courthouse, and provide some concrete services. When issues are identified or raised by participants, these case managers engage in limited crisis intervention while referring the participant back to their treatment counselor. Special advocate case managers monitor child welfare issues that are addressed by a combination of CPS workers, public health nurses, schools, and other specialized service providers. In Kansas City, Department of Family Services (DFS) workers are assigned specifically to the FDTC to provide case management, although when their caseloads are full, other DFS workers help handle the overflow. In Pensacola, the primary counselor from the treatment agency provides case management in combination with other team members. This primary treatment counselor is responsible for written reports to the judge.
Drug Court Review, Vol. VI, 1 101
Virtually every FDTC utilizes some form of drug and alcohol testing to monitor sobriety. Where funding is available, FDTCs require frequent testing, initially as often as multiple times per week. Other courts test on a less frequent and random basis, requiring clients to call in daily and submit to random testing immediately upon request. Since dependency proceedings are civil in nature and there is a lower standard of proof required for court hearings, some FDTCs have moved away from the stringent “chain of custody” protocols required for drug testing in criminal proceedings and utilize less expensive forms of testing, saving the more rigorous and expensive procedures for situations in which the results are contested or contempt proceedings are contemplated.
ADVOCACY
Developing Resources to Meet the Complex Needs of Families
“Advocacy is one of case management's hallmarks. While a professional conducting therapy may speak out on behalf of a client, case management is dedicated to making services fit clients, rather than making clients fit services,” (Siegal, 1998). FDTCs serve as an example of this kind of advocacy. Miami’s Dependency Drug Court has reached out to other community agencies to provide needed services. Aftercare services, ordered at the graduation, are provided by the Project Safe program. They provide peer support, urine testing, and employment assistance. Given the prevalence of traumatic history in their client population, the Miami court also has made arrangements for therapeutic and educational services through another local agency, Victims Services Center.
The Suffolk County court has found that agencies are very willing to adjust their services and service delivery methods to meet the needs of the FDTC participants. Project 102 Family Dependency Treatment Courts
Outreach, a substance abuse treatment program, had a specialized women’s unit when the court began referring clients there. Soon, Project Outreach altered its transportation zones to accommodate the court participants. As participants stayed in treatment longer and domestic violence issues began to emerge, Project Outreach collaborated with the Victims Information Bureau (VIB). VIB provided domestic violence counseling at the Project Outreach treatment facility, rather than have participants attend at the VIB facility some distance away. This accommodated the client’s limited transportation and time constraints, which were already impacted by such responsibilities as parental obligations, 12-step programs, vocational/educational programs, and jobs.
QUESTIONS RAISED
Determining What Model Will Meet the Needs of Families in the Local Community
[16] Family dependency treatment courtswere born out of adult criminal drug courts, a concept so compelling and successful that its application to family court cases was inevitable. After implementing their own versions of these courts, FDTC practitioners’ mantra has become “but it’s not the same as drug court—it’s not just about substance abuse.”
In criminal courts and criminal drug courts, the primary objective is fairly straightforward: stop drug-driven criminal behavior by stopping drug use. In family court dependency cases, however, the objectives are: keep the child safe and give the child a safe and stable permanent home in a child-friendly timeframe by reunifying the child with a sober parent if possible or, if not, by finding an alternate safe, permanent placement with relatives or in an adoptive home. The priority of family reunification can only occur if the underlying problems which brought the family to the attention of CPS and the court are addressed and resolved. Drug Court Review, Vol. VI, 1 103
These issues often extend beyond substance abuse. It is within this context that FDTCs show their divergence from DUI and drug courts.
Is the scope of the FDTC something that lends itself to a national consensus, or is it a matter that must be resolved in local jurisdictions? In deciding the scope, there needs to be agreement about the objectives of FDTCs. Is the focus to secure parental abstinence, and/or to promote family reunification, and/or to assure safe and stable permanent homes for the children in a timely fashion? Should FDTC teams identify and address children’s special needs as part of promoting child well being and family reunification, or should they focus only on parental abstinence?
The first main question to be resolved is: What is the mission of the FDTC? When family courts develop a family dependency treatment court, a pivotal decision is whether its function is to address parental abstinence issues only, or whether the FDTC should address the entire range of issues present in the dependency case. The extent to which they choose to address the range of issues in the dependency case within the FDTC proceedings affects their scope, characteristics, and profile. Jurisdictions choose to be either limited or expansive in their programs for a variety of philosophical, ethical, and practical reasons, and there is wide variation across the country.
Ancillary questions that must be asked include: Is FDTC one feature of a community-wide collaboration of agencies and service providers tasked with meeting the needs of families affected by substance abuse in the child welfare system? Should the FDTC be integrated into the dependency case process or should it stand alone? On one end of the spectrum, there are courts that limit the FDTCs involvement to addressing adult substance abuse with the balance of the dependency case issues being resolved before a different judge in a separate proceeding. On the other end, there are 104 Family Dependency Treatment Courts courts where the entire dependency case comes under FDTC jurisdiction—while adult substance abuse is the precipitating event that makes the case eligible for FDTC, the myriad of other family difficulties, adult and child, are identified, addressed, and monitored by the FDTC as well.
In addition, calendaring practices vary. In FDTCs where the dependency case remains in the home court, the parent’s compliance with substance abuse treatment and abstinence is monitored in the drug court. All decisions on the dependency case, such as increased visitation or return of children, are made in the home court, while contempt of court orders regarding attendance at treatment and remaining abstinent are attended to by the drug court judge. In other courts, a single judge in a single proceeding hears dependency and sobriety issues. Routine case reviews include both parental compliance and dependency case plan progress, including children’s issues and service needs. In the middle are courts where the dependency case and parental compliance with substance abuse conditions of court orders are monitored by the same judge in the same courtroom, but are heard in separate proceedings. For instance, if at a drug court appearance a parent is in compliance and requests additional visitation, that issue is deferred for determination at a separate proceeding in the dependency case where all parties and attorneys may be present and have an opportunity to respond to, and be heard on, the request.
In deciding the scope of the FDTC, jurisdictions must decide whether to follow a one-family/one-judge calendaring practice, or whether there are legitimate logistical or ethical constraints to this practice. Should the same judge who presides over the intense level of judicial monitoring of the FDTC also preside over TPR or other proceedings that may result in the temporary or permanent loss of custody? Is it possible to have all appropriate parties and attorney’s present at every court proceeding or review so that all issues may be resolved as they arise? Drug Court Review, Vol. VI, 1 105
The second main question that must be asked is: How should FDTC interface with the Adoption and Safe Families Act? That is, should FDTCs be mindful of ASFA time frames when structuring their programs? Or should they concentrate on the parent’s sobriety, admitting parents regardless of their dependency case status? ASFA requires the family court to rule on the adequacy of the CPS case plan for reunification. Accordingly, should the FDTC have that responsibility? Should FDTCs have a role in formulating that plan? Should FDTCs be in the business of assessing parent, child, and family difficulties and service needs? At permanency hearings, family courts have to decide if child welfare agencies have made “reasonable efforts” to reunify families. What is the proper role of FDTCs in informing the permanency hearing?
Under ASFA, all states undergo Children and Family Service Reviews. Upon failure to meet federal standards, the state’s department of social services is required to enter into a Program Improvement Plan (PIP) approved by the federal government. FDTCs have a potential impact with respect to whether “[f]amilies have enhanced capacity to provide for their children’s needs,”1. Does the FDTC have a role in meeting the state’s PIP requirements by enhancing that capacity? Does the judicial branch, more particularly, the family court, have a stake or a role in assuring that their state meets the requirements of the PIP? Does FDTC have a role in assuring that needed services are available in their community? Is that role limited to the individual families that come before the FDTC or is that role more expansive in terms of assuring that the community’s array of services is adequate to avoid the financial consequences to the taxpayers if the jurisdiction does not meet the mandates of the PIP? Should FDTCs promote collaboration among the many
1 CFSR Well Being Outcome 1 (Administration for Children and Families, 2007). 106 Family Dependency Treatment Courts service providers who have members of FDTC families as their clients? Moreover, what are the implications of these choices? Can an “abstinence only” drug court be successful in the absence of a broad based community protocol for addressing parental substance abuse? Can an “integrated” drug and dependency court have a positive impact on collaboration across community agencies and services? Finally, what about the many non drug-related dependency cases where outcomes also would be improved if given the level of services and scrutiny afforded FDTC cases? Why should this level of assistance be denied the mentally ill or developmentally disabled parent family? Should FDTCs limit themselves to parental difficulties or should they address the difficulties and obstacles confronting the entire family in their quest for reunification?
This review and posing of questions is intended to promote discussion and debate among FDTC practitioners. The time has come to examine the consequences of choices made in the development of FDTCs to determine which processes and protocols have successfully met the needs of families and children within the context of their individual communities. Furthermore, other more specific operational questions must be addressed in each jurisdiction as they plan. Some of the operational questions raised by each section of this article are contained in Appendix A.
CONCLUSION
Family court has been greatly impacted by parental substance abuse and the rise of caseloads containing parents with co-occurring problems. Simultaneously, the 1997 Adoption and Safe Families Act created additional pressure on the system by requiring the courts and child welfare systems to resolve dependency cases within strict time limits. ASFA also has thrust upon the courts the role of judging the adequacy of efforts made by state departments of social services to assist families and the role of approving or Drug Court Review, Vol. VI, 1 107 modifying the case plan. All this is in addition to the court’s preexisting duty to hear the evidence, determine if there is enough evidence to establish a case, and assure due process to parents, children, and families.
Jurisdictions have been seeking to develop new ways to meet these demands. To that end, family dependency treatment courts have emerged as one solution. FDTCs were adapted from the practices of adult criminal drug courts. While Defining Drug Courts: The Key Components (NADCP, 1997) can provide valuable guidance to FDTCs as well as to adult drug courts, additions and changes must be made to comport with the best dependency court practices and to meet the complex needs of families. The court practices discussed above are some jurisdictions’ attempts to adapt the best features of adult criminal drug courts to dependency court use. Several basic issues still need to be resolved, however, and questions still need to be answered by practitioners in the field, including: Of the practices reviewed, what can be determined about the consequences of the different approaches to the participant families and to practice and procedure in the different FDTC models? Do they respect long held, well thought out, philosophical and ethical jurisprudential considerations? Do they take the best advantage of local resources and opportunities? Are vestiges of historical practices hindering their development? Do they help family court professionals in their jobs and enable the system to function more efficiently? Most importantly, (how) do they benefit families?
Spinak (2002) warns that FDTCs must be vigilant in protecting families: “This commitment to ensuring family integrity must permeate the court’s oversight role for the court to be distinguished from the child welfare agency’s role,” (p. 341). Additionally, she notes that up until now Model Courts and FDTCs have served only a small percentage of dependency cases using their own criteria to include or exclude cases. The time has come to try to take 108 Family Dependency Treatment Courts these pilot projects and expand them to meet the overwhelming demands of child protective cases. Can the design be replicated in all family dependency courts? What modifications will be necessary to enable communities to provide these services to all dependency cases?
As FDTCs evolve and are reproduced across the country, it is time for the leaders of child welfare, the courts, and substance abuse treatment to come together to exchange information on FDTC practices and to build a framework for integrating the best of these practices into all family dependency treatment courts. In so doing, we should not disregard Spinak’s (2002) admonishment that “the purpose that will justify the court’s expanded authority—thus adding value to the family’s life—is the rigorous enforcement of the constitutional principles that recognize the importance of children being raised by their families and not by the state.” (p. 340)
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Administration for Children and Families. (2007, June 30). Child and Family Services Reviews (CFSRs). Child welfare monitoring. Washington, DC: Author, U.S. Department of Health and Human Services. Retrieved August 25, 2007 from http://www.acf.hhs.gov/programs/cb/cwmonitoring/ ndex.htm#cfsr.
Child Welfare League of America. (2001). Alcohol, other drugs & child welfare. Washington, DC: Author.
Department of Health and Human Services. (1999, April). Blending perspectives and building common ground: A report to congress on substance abuse and child protection. Washington, DC: Author.
In re Marino S., 693 N.Y.S.2d 822 (N.Y. Fam. Ct. 1999), aff’d, 741 N.Y.S.2d 207 (N.Y. App. Div. 1st Dep’t. 2002), aff’d, 100 N.Y.2d 361 (N.Y. 2003).
Milliken, J.R. (2001). The dependency court recovery project: Project summary and current highlights. San Diego, CA: San Diego County Superior Court.
National Association of Drug Court Professionals. (1997). Defining drug courts: The key components. Washington, DC: Bureau of Justice Assistance, U.S. Department of Justice.
National Center on Addiction and Substance Abuse at Columbia University. (1999). No safe haven: Children of substance-abusing parents. New York: Author.
New York State Commission on Drugs and the Courts. (2000). Confronting the cycle of addiction and 110 Family Dependency Treatment Courts
recidivism: A report to the chief judge Judith S. Kaye. New York: Author. Retrieved June 10, 2003 from http://www.courts.state.ny.us/reports/addictionrecidiv ism.shtml.
Schecter, S.P. (2001). Family court case conferencing and post-dispositional tracking: Tools for achieving justice for parents in the child welfare system. Fordham Law Review, 70, 2, 427-439.
Siegal, H.A. (1998). Comprehensive case management for substance abuse treatment (TIP No. 27). Rockville, MD: Center for Substance Abuse Treatment.
Spinak, J. M. (2002). Adding value to families: The potential of model family courts. Wisconsin Law Review 2002, 2, 331-376.
Victims of Child Abuse Project. (1995, Spring). Resource guidelines: Improving court practice in child abuse & neglect cases. Reno, NV: National Council of Juvenile and Family Court Judges.
Young, N.K. & Gardner, S.L. (2002). Navigating the pathways: Lessons and promising practices in linking alcohol and drug services with child welfare (SAMHSA Publication No. SMA 02-3639). Washington, DC: Substance Abuse and Mental Health Services Administration.
Young, N.K., Gardner, S.L., & Dennis, K. (1998). Responding to alcohol and other drug problems in child welfare: Weaving together practice and policy. Washington, DC: CWLA Press. Drug Court Review, Vol. VI, 1 111
APPENDIX A
There are many practical questions raised in planning and launching a new FDTC in individual jurisdictions. They must be answered in the context of local resources and practices. Some of those considerations are suggested below. They have been structured to track the sections of the foregoing article.
Permanency Planning in the Best Interest of Children
How should FDTCs interface with ASFA? First and foremost, FDTCs will want to assure their practices are focused on the ASFA priority of the safety and best interest of children. Individual courts already may be following calendar practices tailored to individual state ASFA statutes. If these practices have not yet been employed, planning courts should consider what impact the FDTC could have on improving compliance with ASFA time frames and permanency hearing requirements and factor that into the planning process. Courts may build in protocols to assure the work of the FDTC program is recognized when making reasonable efforts determinations. They also may assure that the progress reported in FDTC court reviews is considered when determining the appropriateness of proposed permanency goals and case plans. Finally, planning courts may wish to review their state’s federally required CFSR and PIP to determine if the local FDTC can respond to some of the requirements to improve their state’s practice.
Necessary Partners
In every jurisdiction, there are partners who must be brought to the table. Since FDTC clearly involves the court, CPS, and treatment, appropriate representatives from those entities must be present. The array of local treatment resources will inform the decision to include the governmental licensing agency and/or the substance abuse 112 Family Dependency Treatment Courts treatment providing agencies. A determination of which other agencies in the community are providing services to the families who will participate in the FDTC and consideration of including them in the planning process will be required.
In this process, the court and stakeholding agencies will examine and question their appropriate role. Judges will consider how their role as a community leader in this effort is shaped by judicial and ethical considerations. Similarly, determinations will be made concerning the nature and extent of judicial and court leadership in developing the FDTC and securing services necessary to assist the families involved. Other partners will examine how to maximize their participation in shaping the treatment court to best benefit families as well as individual agencies and parties they represent, while maintaining appropriate role boundaries once the FDTC becomes operational.
In engaging and maintaining collaboration with partners in the FDTC, cross-systems communication is critical to its success. Localities will have to develop communications protocols that comport with state and federal confidentiality requirements. Once appropriate waivers of confidentiality have been agreed upon, FDTCs must then develop protocols for timely and reliable communication systems. Not only must information be communicated, responses to that information must be coordinated. FDTCs will determine which agencies or individuals will be responsible for managing the information exchange and coordinating the team’s response to events. In the course of developing these protocols, teams must take into account the dynamics of addiction and recovery and avoid practices that permit participants to manipulate team members who may then inadvertently enable addictive behaviors.
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Defining the Mission of FDTCs
As local jurisdictions define the mission of their FDTC, they will determine the range of case issues that will come under its umbrella. The FDTC may be expansive in scope to include not only parental substance abuse, but also all of the issues that brought the family before the court in the dependency case. Or, the FDTC may be limited to parental substance abuse issues only, with the dependency case issues being addressed elsewhere. The mission and case issues included in the scope of the FDTC will impact case management and identification of necessary partners.
The team will determine the location of the hub of coordination, collaboration, and communication concerning the case plan. It may be court based, centered in CPS, or contracted out to a not-for-profit agency or substance abuse treatment provider. Deciding both which entity has the capacity to perform various functions and the appropriate roles for the court and other agencies will entail practical as well as philosophical considerations.
Exercising Legal Jurisdiction and Intake
State law dictates the type of jurisdiction for FDTCs. In some states, FDTCs will be limited to dependency cases only. In states where the court has broader jurisdiction, a determination must be made as to what other types of cases (i.e., criminal matters) involving the same family will be heard by the FDTC judge and incorporated into the case plan.
The second question regarding jurisdiction is at what point in the life of a case a parent should be considered for FDTC. Some courts will admit the parent as early as the first court appearance, while others may decide it is appropriate to wait until the parent has failed to comply with court orders to engage in AOD treatment and remain abstinent. Jurisdictions 114 Family Dependency Treatment Courts also will need to consider the status of the case relative to ASFA time frames.
Court Calendaring Practices
Some FDTCs utilize the direct one-family/one-judge calendaring practice, keeping all issues in one courtroom and the focus on timely permanency for children. Other jurisdictions maintain the dependency case before one judge and send the parent to another judge or magistrate for the monitoring of compliance with substance abuse treatment and abstinence. This latter practice sometimes develops based on logistical considerations or concerns over whether it is appropriate for one judge to hear the FDTC status hearings as well as modification (such as return or removal of children) and TPR proceedings.
Phase Structure and Managing Client Behavior
FDTCs generally measure parental progress through the program by phases. Movement from one phase to the next is based on the achievement of certain milestones. Accomplishments should be agreed upon across disciplines and, depending on the structure of the court, may include milestones in the permanency/dependency service plan requirements, meeting parental obligations, lifestyle changes to support abstinence along with substance abuse treatment participation and progress. Whether these milestones are divided into three, four, or five phases is a matter of local preference.
Sanctions, incentives, and consequences are integral to motivating parents to comply. Teams will need to discuss a schedule of sanctions and incentives and determine how they can be consistently applied. Jurisdictions will have to explore what rewards are available within their community. With respect to determining appropriate sanctions, courts will first be guided by local law. While incarceration for Drug Court Review, Vol. VI, 1 115 contempt may be legally available, local custom or judicial preference may dictate whether or not it will be employed. Teams also will need to educate themselves about relapse to determine when a “response” to address the circumstances of the relapse is more appropriate than a sanction.
Structure of the FDTC
Three levels of support are needed for FDTCs. First is acceptance and support of the FDTC mission and overall policy from the highest level of leadership of each entity involved. Second is agreement by supervisory personnel on protocols and practices that will be used in the FDTC. Third comes from the individuals who will actually be carrying out the work of the FDTC when it becomes operational. These levels of support may be garnered in a steering committee of high ranking officials, a planning and administrative oversight committee of managerial personnel with sufficient authority to agree to protocols and practices on behalf of their agencies/entities, and finally an operational team who is trained to utilize the protocols and practices while working directly with the families. Depending on the size of the community, these may be three distinct groups of individuals or membership may overlap completely or in part. Identifying the right individuals to fulfill these functions will have long lasting impact on the success of the FDTC.
Case Management
FDTCs will have to determine how case management will operate. Initial screening to determine eligibility for participation must occur and clinical and programmatic criteria will need to be developed. For instance, teams will have to assess their ability to work with parents with co- occurring disorders, such as mental illness.
FDTCs require the availability of assessments in order to plan appropriate services. Beyond looking at levels 116 Family Dependency Treatment Courts of AOD use and abuse, FDTCs, depending on their scope, must consider assessments of co-occurring disorders, the presence of domestic violence, mental health concerns, family service needs, and children’s health and developmental issues. After deciding what should be assessed, the team will have to agree on the assessment process including what instruments will be used and which team members will be responsible for what parts of the assessment.
The next logistical concern is formulating a case plan to meet the identified needs. The overall case plan must be developed and the multiple service plans of individual entities (CPS, treatment, children’s services) must be coordinated.
Families must be linked to services. Not every parent will need the same level of substance abuse treatment, so a continuum of levels will have to be sought. As families will need other services, FDTCs will have to decide how extensive the services under its auspices will be. The court may or may not decide to address housing, vocational training, child development, child health, parent health, day care, and transportation.
A team member will need to be designated to “broker” services or refer cases. Service providers must be selected and their responsibilities to FDTC delineated. Written reports or attendance at staffings may be required, and participants, families, and case plans must be monitored. The team must decide whether CPS, a treatment provider, an independent agency, or a court employee will take responsibility for the monitoring. Depending on the scope of the FDTC and the information to be monitored, this responsibility may include substance abuse issues only or may embrace the entire case plan.
Drug and alcohol testing must be incorporated into FDTC operations. Frequency, payment for testing, Drug Court Review, Vol. VI, 1 117 individuals to administer the test, testing protocols including test kits, what substances are tested for and how to assure tests are random and reliable, are all problems to be solved by the team.
FDTCs often engage in some form of advocacy on behalf of their families and programs. FDTCs role in developing resources to meet the complex needs of its families and the roles of the professional staff and the judge in developing resources are other questions to be debated. Other issues for planning FDTC teams to ponder include their ability to bring the program to scale to serve all parents in the community charged with neglect where substance abuse is an issue. Planning jurisdictions should maintain their focus on adding value to the lives of families while serving to reorganize the process for enhanced professional collaboration. In the excitement of developing a program that will increase success in reuniting children with sober parents, FDTCs also must assure they are sufficiently safeguarding parents’ and children’s due process rights. 118 Family Dependency Treatment Courts
Drug Court Review, Vol. VI, 1 119
APPENDIX B
POLICY AND PROCEDURE MANUALS REVIEWED
Albany County Family Treatment Court Gerard E. Maney, Judge David B. Cardona, Chief Clerk One Van Tromp Street Albany, NY 11207 (518) 427-3592
Durham County Family Treatment Court Elaine O’Neal, Judge Office of Trial Court Administration Durham County Judicial Building 201 E. Main Street, Suite 278 Durham, NC 27701 (919) 564-7210
El Paso Family Dependency Treatment Court Program Alfredo Chavez, Judge Annabell Casa-Mendoza, Coordinator 65th District Court 500 E. San Antonio, Suite 1105 El Paso, TX 79901 [email protected] (914) 834-8216
Erie County Family Treatment Court Margaret O. Szczur, Judge Erie County Department of Social Services 478 Main Street, Room 604 Buffalo, NY 14202 (716) 858-7954
Or
120 Family Dependency Treatment Courts
Erie County Family Court 1 Niagara Square Buffalo, NY 14202 (716) 858-4764
Escambia County Family Focused Parent Drug Court John J. Parnham, Judge 2251 N. Palafox Street Pensacola, FL 32501
Or
Robin Wright, Sr. Deputy Court Administrator 100 W. Maxwell St. Pensacola, FL 32501 [email protected] (850) 595-3055
Idaho 7th Judicial District Child Protection and Parent Drug Court P.O. Box 389 Rexburg, ID 83440 (208) 656-3243
16th Judicial Circuit Jackson County Family Drug Court Molly Merrigan, Commission Penny Howell, Administrator 625 E. 26th Street Kansas City, MO 64108 (816) 435-4757
Manhattan Family Treatment Court/New York County Family Court Gloria Sosa-Lintner, Judge 60 Lafayette Street New York, NY 10013 (212) 374-2526
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Mecklenburg County Family Treatment Court/ F.I.R.S.T. (Families in Recovery Stay Together) 800 East Fourth Street, Suite 211 Charlotte, NC 28202 (704) 358-6216
Miami-Dade County, Florida Dependency Drug Court Jeri B. Cohen, Judge Paul Indelicato, Director 3300 NW 27 Avenue Miami, FL 33142 (305) 638-6102
Suffolk County Family Treatment Court Nicolette M. Pach, Judge Joan Genchi, Judge Christine Olsen, Director 400 Carleton Avenue Central Islip, NY 11702
Washoe County, Nevada Family Drug Court Charles McGee, Judge P.O. Box 30083 Reno, NV 89520 (775) 325-6769
Westchester County Family Treatment Court Westchester County, NY
Yellowstone County Family Drug Court Susan Watters, Judge Becky Bey, Coordinator Child and Family Services Building 2525 4th Avenue North Billings, MT 59101 (406) 657-3156
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Family Drug Treatment Courts:
A Place for Judicial Activism? by the Honorable Angela Edwards Roberts © Comstock
ocrates asserted four traits belonging to resent a difficult workload....For children, out breach of judicial ethics when a team Sa judge: to hear courteously, to answer they are a tragedy.” 3 of professionals, led by the J&DR court wisely, to consider soberly and to decide judge, works collaboratively to help fami- impartially.1 The tug-of-war between judi- This onslaught of family dysfunction has lies effectively deal with substance abuse. cial restraint and judicial activism was dramatically changed the role of the fam- probably not part of Socrates’s thinking, ily court judge, and, more than ever, Further Identifying the Problem but has become a political concern over Socrates’s observation must be heeded. With the passage of the federal Adoption recent decades. In the midst of hot-button Like our colleagues in other states, and Safe Families Act of 1997 (ASFA) politics, however, family court judges Virginia’s Juvenile and Domestic Relations (Public Law 105-89), Congress mandated nationwide have been responding to the District Court (J&DR) judges are respond- that children in the foster care system have nature and number of cases overwhelming ing to this deluge by assuming judicial a permanent placement within twelve their dockets. Chief Justice Judith S. Kaye roles and trying approaches that may months of entering the system.4 For par- of New York described in Newsweek appear unorthodox, even activist, in ents who were substance abusers, this pre- exploding caseloads fueled by drug abuse, nature. One of these is the family drug sented a particular challenge. Assuming domestic violence and family dysfunction: treatment court (FDTC). they wanted addiction treatment, waiting “The flood of cases (into the courts) shows lists were long, court dockets were no sign of letting up. We can either bail The objective of this article is to inform crowded, and the likelihood of relapse faster or look for new ways to stem the lawyers and judges about these new could easily place them outside the tide.” 2 Chief Justice Leah Ward Sears of courts and to encourage judges to be twelve-month time frame. Could a law Georgia wrote about it in the Washington involved in this innovation. This article whose intent was to place children in lov- Post: “Fragmented families are flooding asserts that family drug treatment courts ing, permanent homes rather than allow- our court dockets.... For judges they rep- allow for collaborative intervention with- ing them to languish in the foster care
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system for years have the unintended drug treatment court, today the number effect of separating families that might rea- of operational drug treatment court pro- Defining Drug Courts: sonably be reunited? grams in the state has grown to twenty- The Key Components nine. There are sixteen adult felony 1. Drug courts integrate alcohol and other drug Fearing this reality and searching for a courts, one adult driving-under-the-influ- treatment services with justice system case solution to the problem, child welfare pro- ence drug treatment court, eight juvenile processing. ponents borrowed principles from adult drug treatment courts and four family 2. Using a non-adversarial approach, prosecu- drug courts started in 1989, and applied drug treatment courts. These four FDTCs tion and defense counsel promote public safety while protecting participants’ due the principles to create FDTCs. are currently making a difference in process rights. These courts are a juvenile or family court Alexandria, Charlottesville/Albemarle 3. Eligible participants are identified early and docket of which selected abuse, neglect, County, Newport News and Richmond. promptly placed in the drug court program. and dependency cases are identified 4. Drug courts provide access to a continuum of where parental substance abuse is a pri- Virginia has strong judicial, legislative and alcohol, drug, and other related treatment mary factor. Judges, attorneys, child pro- executive support for the continuation and and rehabilitation services. tection services, and treatment and other expansion of drug treatment courts. 5. Abstinence is monitored by frequent alcohol social and public health personnel unite Because these programs represent the and other drug testing. with the goal of providing safe, nurturing, most successful and cost-effective 6. A coordinated strategy governs drug court and permanent homes for children while approach to dealing with drug-addicted responses to participants’ compliance. simultaneously providing parents the nec- offenders. advocates continue to seek per- 7. Ongoing judicial interaction with each drug essary support and services to become manent and stable sources of funding. 9 court participant is essential. drug and alcohol abstinent.5 Chief Justice Leroy R. Hassell Sr. com- 8. Monitoring and evaluation measure the mented in his address to the Virginia Drug achievement of program goals and gauge effectiveness. These courts are civil in nature and have a Court Association, September 30, 2005: sense of urgency to rehabilitate partici- 9. Continuing interdisciplinary education pro- motes effective drug court planning, imple- pants within the mandated time frame. As I review the preliminary data, as I mentation, and operations. The ultimate sanction for failure is not receive letters from graduates of drug 10. Forging partnerships among drug courts, incarceration as in adult drug court, but courts, as I interact with participants public agencies, and community-based loss of parental rights. Because alcohol in drug court programs and listen to organizations generates local support and and drug abuse have been identified as their life stories, as I see families enhances drug court program effectiveness. the cause of seven out of ten child abuse reunited, marriages restored, and job- (NADCP, 1997). and neglect cases, the need for these less, unproductive people who were courts is critical.6 once, through their own fault albeit, every drug court.13 (See sidebar.) These existing in a cycle of despair, as I include requiring early case screening and In 2004, the Conference of Chief Justices observe these people being trans- assessment; prompt referral and access to and the Conference of State Court formed into productive, taxpaying cit- a continuum of treatment and rehabilita- Administrators adopted a national joint izens, I conclude that, yes, drug tion services; a coordinated strategy to resolution committing all fifty state chief courts work. I conclude that, yes, govern responses to participants’ compli- justices and state court administrators to drug courts are needed.10 ance; partnerships with public agencies, “take steps, nationally and locally, to treatment providers, attorneys, commu- expand and better integrate the principles Indeed, this thinking is consistent with that nity-based organizations and others; and and methods of well-functioning drug of Thomas Jefferson, who stated, “The regular and active judicial supervision.14 courts into ongoing court operations.” 7 care of human life and happiness, and not their destruction, is the first and only legit- FDTCs normally use a team approach to Family Drug Treatment Courts imate object of good government.” 11 If handle cases. Judge, attorney, social in Virginia alcoholism and drug addiction are worker, substance abuse/mental health Virginia established its first drug treat- accepted as treatable and preventable dis- worker, court appointed special advocates ment court in 1995 as a result of the judi- eases, states should address them through and others are all a part of the team of ciary’s efforts to find more effective a public health strategy with the goal of professionals that provide support needed methods to handle the escalating number long-term recovery.12 to deal with addiction. The court convenes of drug offenders on Virginia’s court on a weekly basis. The team of profes- dockets. This reflected the philosophy How Family Drug Treatment sionals keeps participants accountable by that more effective handling of drug treat- Courts Operate ordering various evaluations, urine ment for addicts would result in higher Common practices and key components screens, Alcoholics Anonymous or recovery rates and reduced criminal adopted by the National Association of Narcotics Anonymous meetings, job behavior.8 Initially starting with one adult Drug Court Professionals are essential to searches or whatever else the court may
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deem appropriate. Inpatient services and concerns for the drug court judge. I will The Code requires impartiality, not disen- detoxification programs are often only focus on four of the most common. gagement. A judge can show concern absolutely necessary. about a participant’s progress in recovery, As noted previously, a coordinated strat- yet can also extend the same quality of In some cases, children of recovering par- egy governs court responses to compli- engagement and concern to all partici- ents are removed from their homes. In ance. This strategy used by all drug courts pants to avoid the appearance of impro- other cases, children are able to remain involves “staffing,” in which members of priety.21 If the judge maintains an active, with a parent or guardian. As long as a the drug court team meet in advance of supervising relationship throughout treat- participant is in the FDTC, he or she gets the participant’s hearing to discuss the par- ment, the likelihood increases that a par- credit for working toward reunification, ticipant’s progress in treatment and to ticipant will remain in treatment and with the incentive being a desire to not reach consensus about rewards and sanc- improve the chances for reaching sobriety lose custody of his or her children. tions. As a judge becomes part of this col- and family reunification. Therefore, the time period may extend laborative decision-making team that beyond the twelve-month ASFA-mandated includes treatment providers, court per- All drug courts should forge partnerships period. The key is to provide community sonnel and attorneys, the judge’s involve- among drug courts, public agencies and resources along with the accountability the ment may appear to undermine community-based organizations to gener- law requires. perceptions of judicial independence and ate local support and enhance drug court impartiality. Canon 1(A) states: program effectiveness. Ethical concerns If a community determines that family drug are raised when the independence or treatment court would be a welcomed An independent and honorable judi- impartiality of the judiciary comes into alternative to traditional procedures but the ciary is indispensable to justice in our question. As long as the focus of collabo- number of participants who would take society. A judge should participate in rative work in this area is to educate about advantage of such an opportunity is small, establishing, maintaining and enforc- drug court practices and procedures, there a regular J&DR docket could feasibly ing high standards of conduct, and should be no ethical problems. Caution handle the cases with an intensive team shall personally observe those stan- should be taken when partnering with law approach. Clearly though, larger num- dards so that the integrity and inde- enforcement so as to not appear to be act- bers of waiting participants who could pendence of the judiciary will be ing as an instrument of law enforcement. encourage judges and family law practi- preserved.17 Where court-community partnerships tioners to check into starting one in their cooperate in the exchange of information, community. For further information on It is submitted that the collaborative deci- ethical concerns should be minimal or Virginia drug treatment courts, please sion-making process, however, does not nonexistent. Community organizations visit www.courts.state.va.us/dtc/home.html. violate the judge’s duty of independent that educate the court about available judgment so long as the final decisions resources merely serve to aid the court’s Judicial Ethics remain with the judge. The judge may not disposition of cases. Partnerships should The key to the success of any drug court delegate this final decision making to never include discussion of specific cases rests on the professional role of the judge other members of the drug court team.18 that are pending in the court, nor should as leader in the drug court process. The they cast any doubt on the judge’s capac- role of the judge changes from the tradi- All drug courts require the judge’s per- ity to act impartially.22 tional passive one to a more active one. sonal engagement with each participant “No longer are courts and judges uni- throughout the drug court experience. Finally, certain concerns about impartiality formly shying away from these issues This dynamic is crucial to the successful and dignity may arise from a judge’s con- because they may entail ‘social work.’ completion of treatment and other pro- duct both inside and outside of the court- Instead many judges are becoming knowl- gram requirements. The ethical concern room in drug courts. Praising, hugging and edgeable about substance abuse causes, here is that of avoiding the appearance of clapping for participants are inconsistent symptoms, behaviors and treatments, as impropriety. The judge’s personal engage- with normal courtroom behavior, but quite well as issues relating to recovery, relapse, ment must not conflict with the judge’s common in drug courts. Likewise, judges and family dysfunctions.” 15 As drug courts position as a detached arbiter who is blind attending social gatherings (like a picnic) are becoming more accepted in the legal to the parties before the court.19 Canon with parties before the court is not cus- community, the issue of the proper ethical 2(A) states: tomary, but is common in drug courts. role of judges in the process continues to A judge shall respect and comply Canon 3(B) states: be debated. “In all judicial proceedings, the with the law and shall act at all times judge bears the ultimate responsibility for in a manner that promotes public A judge shall require order and deco- ensuring that the parties receive a fair hear- confidence in the integrity and impar- rum in proceedings before the ing in a dignified forum.” 16 Each of Judicial tiality of the judiciary.20 judge.23 Canons 1 through 5 raises unique ethical
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Realizing that a drug court’s goal is to brought on by drug abuse. Virginia’s Courts: Models and Trends, paper presented to the National Center for State Courts (NCSC) July 8, actively promote the successful treatment J&DR judges are responding to the nature 2003. of participants rather than to mediate a and number of cases overwhelming 16 Ethical Considerations for Judges and Attorneys in dispute between two litigants, a judge family court dockets, and the family drug Drug Court, National Drug Court Institute (May may participate in these activities to pro- treatment courts are making a difference 2001) at 1. 17 Rules of the Virginia Supreme Court of Virginia, mote the objectives of the drug court. The in the lives of Virginia’s children and Part Six, Section III, Canons of Judicial Conduct for judge must, however, remain impartial their families. q the State of Virginia. Canon 1 (A) (hereinafter and dignified and treat all participants Canons) equally; not discuss or transact business 18 Ethical Considerations, supra note 15 at 3. with participants outside of the court- Endnotes: 19 Ethical Considerations, supra note 15 at 5. room; keep outside gatherings open to all 1 Quoted in Wright, Courtroom Decorum and the 20 Canon 2(A), supra note 16. Trial Process, 51 JUDICATURE 378, 382 (1068). participants; and never be alone with a 21 Ethical Considerations, supra note 15 at 5. 2 Hon. Anthony J. Sciolino, The Changing Role of the 22 Ethical Considerations, supra note 15 at 5. single participant.24 Family Court Judge: New Ways of Stemming the Tide, 3 CARDOZO PUB. L. POL’Y & ETHICS J. 395 23 Canon 3, supra note 16. (2005), quoting Chief Justice Kaye from a 24 Ethical Considerations, supra note 15, at 8. The Benefits of Family Drug NEWSWEEK 1999 article. Treatment Courts 3 Hon. Leah Ward Sears, A Case for Strengthening 25 The Honorable Leonard Edwards, Judicial Perspectives on Family Drug Treatment Courts, 56 Family drug treatment courts have been Marriage, THE WASHINGTON POST, Oct. 30, 2006, at A17. JUVENILE & FAM. CT. J. 3 (Summer 2005). shown to benefit families, courts and the 4 Applying Drug Court Concepts in the Juvenile and Acknowledgement— community. They shorten a child’s time in Family Court Environments: A Primer for Judges The author wishes to thank and acknowledge the foster care by identifying substance abuse (June 1998) at 16 [hereinafter PRIMER]. assistance of Professor Lynne Marie Kohm, John Brown McCarty Professor of Family Law, Regent issues early and starting treatment. Also, 5 Painting the Current Picture: A National Report Card on Drug Courts and Other Problem Solving University and law school liaison for the Virginia State because of the individualized case plan Court Programs in the US, Bureau of Justice Bar Family Law Section Board of Governors. and the drug court team’s close monitor- Assistance (BJA), National Drug Court Institute (NDCI)(May 2005), at 12 [hereinafter Report Card]. ing, the participant is more likely to suc- 6 National Center on Addiction and Substance ceed. If the participant fails the program, Abuse at Columbia University, New York, NY there is usually no question that reason- (1999). No safe haven: Children of substance abus- ing parents. able efforts to rehabilitate have been pro- 7 Report Card, supra note 5, at 9. See also vided and the case can move toward Therapeutic Jurisprudence and the Drug permanency. Because the time in foster Treatment Court Movement: Revolutionizing the Criminal Justice System’s Response to Drug Abuse care is shortened, communities save and Crime in America, 74 NOTRE DAME L. REV. money. Family drug courts can serve as an (Jan. 1999). effective preventive intervention for 8 Virginia Drug Treatment Courts Program (VDTCP) addicted parents by preventing babies Web site at www.courts.state.va.us/dtc/home.html 9 For further discussion of policies to improve the from being born to a substance-abusing ways states organize and deliver alcohol and drug mother.25 prevention and treatment see “Blueprint for the States: Findings and Recommendations of a National Policy Panel. Join Together.” 2006 (here- Socrates’s wisdom is alive in Virginia’s inafter Blueprints) at www.jointogether.org. FDTCs as the J&DR judge utilizes a team 10 VDTCP, supra note 8. of community-based professionals to hear 11 Quoted in Therapeutic Jurisprudence, supra note 7 courteously, answer wisely, consider at 439. soberly, and decide impartially in an area 12 “Blueprint,” supra note 9 at 8. of life and law where solutions are very 13 Defining Drug Courts: The Key Components (National Association of Drug Court Programs, difficult to harness. Rather than being a 1997) model of judicial restraint, family drug 14 See Report Card, supra note 5 at 10. 10 Key courts represent judicial activism to con- Components. front the onslaught of family dysfunction 15 Primer, supra note 4, at 6. See also Pamela M. Casey and David B. Rottman, Problem-solving
The Honorable Angela Edwards Roberts is a judge on the Richmond Juvenile and Domestic Relations District Court. She is a member of the board of governors of the Virginia State Bar Family Law Section; the VSB Professionalism Course Faculty; the Chief Justice’s Indigent Defense Training Commission; and the Governor’s Commission on Sexual Violence. She holds a political science degree from Virginia Tech and she received her law degree from Emory University School of Law.
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FDC Literature Review: Annotated Bibliography
Drug Court Overview and Approaches/Models
Ashford, J.B. (2004). Treating substance-abusing parents: A study of the Pima County family drug court approach. Juvenile and Family Court Journal, 4, 27-37. doi: 10.1111/j.1755-6988.2004.tb00171.x
A geographical comparison-group design was used to examine the effectiveness of the Pima County (Arizona) Court Assisted Treatment Services (CATS) program and its drug court intervention. The study compared the summary statistics for the volunteers to the family drug court (n=33) with a treatment-refusal group (n=42) and a treatment-as-usual group (n=45) from a matched geographical area. The findings of this study indicate that the family drug court group had higher engagement and completion rates of residential treatment than was true of the other comparison groups. In addition, the volunteers to the family drug court group had fewer parental rights severed, a higher percentage of permanency decisions reached within one year, earlier permanency decisions, and a higher percentage of children placed with their parents. The implications of this study's findings for future evaluations of the components of a family drug court intervention are discussed.
BJA. (2004). Family dependency treatment courts: Addressing child abuse and neglect cases using a drug court model. Rockville, MD: U.S. Dept. of Health and Human Services. Center for Substance Abuse Treatment
Bryan, B. & Havens, J. (2008). Key linkages between child welfare and substance abuse treatment: Social functioning improvements and client satisfaction in a family drug treatment court. Family Court Review, 46, 151-162. doi: 10.1111/j.1744- 1617.2007.00189.x
This article summarizes early findings regarding social functioning and client satisfaction from a longitudinal study of women receiving treatment in a family drug treatment court located in the Midwestern United States (N= 33). Drug treatment court participants were interviewed at program entry and when they had completed 6 months of treatment. Family drug court participants reported significant improvements in employment status and increases in earned income after 6 months of treatment. Respondents also reported improved social functioning and high overall levels of satisfaction with treatment. Findings and implications for future research are discussed.
Cannavo, J.M., &Nochajski, T.H. (2011). Factors contributing to enrollment in a family treatment court. The American Journal of Drug and Alcohol Abuse,37(1), 54-61. DOI:10.3109/00952990.2010.535579
The literature has shown that standard drug courts have had some success in reducing recidivism. As a result of drug court success, there has been an extension of therapeutic courts into other areas, including family courts. Characteristics that identify those who are likely to refuse entering a Family Treatment Court (FTC) can provide insight into how refusal rates may be decreased. This study evaluated FTC enrollment to identify predictors that may aid in the development of interventions to decrease refusal rates. A total of 229 referrals to the FTC were included in this study. Comparisons were made across a number of factors between those who chose to enroll in the FTC and those who did not. Binary logistic regression modeled the effect of independent variables on the probability of enrollment. There were high rates of mental health problems, with high rates of trauma exposure in the sample, consisting mostly of females. Race, government assistance, severity of substance use problems, motivation to change substance use behavior, and parent–child interactions were significant predictors of enrollment. The results for the study point out the need for possible specialized treatments and a need to consider how motivational elements may be addressed during the intake assessment to aid in decreasing refusal rates. Additionally, the results point toward a need for consideration of family system approaches when working with FTC participants as well as the need for further work with motivational elements and drug court participants. Dakof, G.A., Cohen, J.B., & Duarte, E. (2009). Increasing reunification for substance- abusing mothers and their children: Comparing two drug court interventions in Miami. Juvenile and Family Court Journal, 60, 11-23.
This study provides a quasi-experimental test of 80 consecutive enrollments in the Miami- Dade (Florida) Dependency Drug Court in order to examine the impact of a family-based and gender specific intervention, Engaging Moms Program (EMP), on drug court graduation and family reunification. We compared EMP with case management services (CMS). Results indicated that 72% of mothers in the EMP graduated from drug court, and 70% were reunified with their children. In contrast, 38% of mothers receiving CMS graduated from drug court, and 40% were reunited with their children. EMP, then, appears to be a promising family drug court intervention.
Dakof, G.A., Cohen, J.B., Henderson, C.E., Duarte, E., Boustani, M., Blackburn, A., Venzer, E. & Hawes, S. (2010). A randomized pilot study of the Engaging Moms Program for family drug court. Journal of Substance Abuse Treatment, 38, 263-274. doi: 10.1016/j.jsat.2010.01.002
In response to the need for effective drug court interventions, the effectiveness of the Engaging Moms Program (EMP) versus Intensive Case Management Services (ICMS) on multiple outcomes for mothers enrolled in family drug court was investigated. In this intent-to-treat study,mothers (N = 62) were randomly assigned to either usual drug court care or the Engaging Moms drug court program. Mothers were assessed at intake and 3, 6, 12, and 18 months following intake. Results indicated that at 18 months post drug court enrollment, 77% of mothers assigned to EMP versus 55% of mothers assigned to ICMS had positive child welfare dispositions. There were statistically significant time effects for both intervention groups on multiple outcomes including substance use, mental health, parenting practices, and family functioning. EMP showed equal or better improvement than ICMS on all outcomes. The results suggest that EMP in family drug court is a viable and promising intervention approach to reduce maternal addiction and child maltreatment.
DeMatteo, D., Filone, S., & LaDuke, C. (2011). Methodological, ethical, and legal considerations in Drug Court research. Behavioral Sciences & the Law, 29(6), 806-820.
Since their inception in the late 1980s, drug courts have become the most prevalent specialty court in the United States. A large body of outcome research conducted over the past two decades has demonstrated that drug courts effectively reduce drug use and criminal recidivism, which has led to the rapid proliferation of these courts. Importantly, drug court research has flourished despite the many challenges faced by researchers when working with a vulnerable population of justice-involved substance users. In this article, we highlight the most common methodological, ethical, and legal challenges encountered in drug court research, and discuss ways in which researchers can overcome these challenges to conduct high-quality research. Drug court research exemplifies how rigorous empirical investigation can be accomplished in the criminal justice system, and it can serve as a useful model for researchers working in other parts of the judicial system.
Dice, J.L., Claussen, A.H., Katz, L.F., & Cohen, J.B. (2004). Parenting in dependency drug court. Juvenile and Family Court Journal, 55(3), 1-10.
This article discusses the underlying approach and philosophy of the Miami-Dade Dependency Drug Court (DDC), which addresses the needs of families affected by substance abuse through a comprehensive and therapeutic approach. The DDC works with community agencies to provide services that effectively treat the family as a unit. The DDC provides a model approach to addressing risk factors associated with substance abuse in families and a model approach to collaboration with community stakeholders. This article discusses the process of adapting a parenting program to meet the needs of families in the DDC.
Family court and outpatient treatment hoped to lead to more reunification. (2008). Alcoholism & Drug Abuse Weekly, 20(20), 1-6.
The article reports on the joint effort of the Department of Human Resources (DHS) and the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) to improve parent reunification in the state. The two agencies believe that the problems in the state's foster care system could be solved by expanding the family court program, which aims to reunify parents who are substance-dependent. They funded the assessment and treatment for these parents. [PUBLICATION ABSTRACT]
Kuhn, J.A. (1998). Seven-Year Lessons on Unified Family Courts: What We Have Learned since the 1990 National Family Court Symposium. Family Law Quarterly, 32, 67-93.
In October 1990, the National Council of Juvenile and Family Court Judges conducted "a first of its kind" symposium that addressed the topic of unified family courts. Teams of three to five judges, court professionals, legislators, and service providers from over twenty states attended the program to identify and offer to state courts a series of recommendations for implementation of a model family court. The product of this symposium, Recommendations for a Model Family Court, l also known as the "Redbook," has been heavily relied upon during the last seven years by persons all over the country who have sought to improve the justice system's response to children and families by creating a unified family court.
Lesperance, T., Moore, K.A., Barrett, B., Young, S., Clark, C., &Ochshorn, E. (2011). Relationship between trauma and risky behavior in substance-abusing parents involved in a family dependency treatment court. Journal of Aggression, Maltreatment & Trauma 20(2), 163-174.
This exploratory study examined participants in a Family Dependency Treatment Court (FDTC), designed for substance-abusing parents whose children were removed from the home. Twenty-five participants were interviewed one year after FDTC enrollment to assess retrospectively the relationship between trauma history and risky behaviors. Treatment compliance rates were found to be high, and most participants had negative urinalysis results. Qualitative analyses revealed that approximately half of the participants attributed decreases in risky behaviors to the FDTC program. This study increases understanding of the effect of substance abuse and trauma on high-risk behaviors and might help to improve services for substance-abusing parents involved in the child welfare system. Finally, the future success of reducing child abuse and neglect and parental substance use could hinge on the partnership between judicial and substance abuse treatment through FDTCs. Findings from this exploratory pilot study should be replicated with more representative and larger samples.
Malbin, D.V. (2004). Fetal alcohol spectrum disorder (FASD) and the role of family court judges in improving outcomes for children and families. Juvenile and Family Court Journal, 55(2), 53-63.
The purpose of this article is to support increased recognition and efficacy of services for people with Fetal Alcohol Spectrum Disorder (FASD) in the legal system. FASD is under-reported, under-diagnosed, and over-represented in juvenile justice. Prenatal alcohol and other drug exposure causes brain damage that affects behaviors, e.g., poor judgment, impulsivity, difficulty learning from experience, and difficulty understanding consequences, leading to multiple diagnoses such as Attention Deficit Disorder, Conduct Disorder, Oppositional Defiant Disorder and Emotionally Disturbed. FASD is an invisible physical disability; most people with FASD have no observable physical characteristics. The courts are in an important position to increase awareness of this problem by simply asking whether FASD is a factor that needs to be considered. This article includes: (1) an overview of FASD diagnostic criteria and current terminology; (2) exploration of FASD as a physical disability with behavioral symptoms; (3) a case example illustrating common patterns of behaviors in children and adults with FASD without identification and improved outcomes following identification and implementation of appropriate treatment; and (4) recommendations for family court judges. The courts are in an important position to increase awareness of this problem by encouraging advocates and professionals to learn more about FASD and to take it into account when making recommendations to the court.
National Center on Substance Abuse and Child Welfare (2011). Introduction to cross-system data resources in child welfare, alcohol and other drug services, and courts. US Department of Health and Human Services: Rockville, MD.
This guide was developed for use by management and administrative officials at the State, county, and tribal level who wish to develop cross-system relationships in child welfare, alcohol, and other drug services, and court systems. The guide presents detailed information on five child welfare data-reporting systems, three other child welfare data systems, five alcohol and other drugs system data, two court system information sources, two tribal child welfare data systems, and one tribal health system data source. The child welfare data-reporting systems are the Statewide Automated Child Welfare Information System, the Adoption and Foster Care Analysis and Reporting System, the National Child Abuse and Neglect Data System, the National Youth in Transition Database, and the Child and Family Services Review. Other data systems discussed include the Longitudinal Studies of Child Abuse and Neglect, the Center for State Foster Care and Adoption Data, the National Data Analysis System, the Treatment Episode Data Set, the National Survey of Substance Abuse and Treatment Services, the Inventory of Substance Abuse Treatment Services, the National Survey on Drug Use and Health, and the National Outcome Measures for Co-Occurring Disorders. Additional systems include the National Consortium on State Court Automation Functional Standards, Dependency Court Performance Measures, child welfare data from the Bureau of Indian Affairs and the HIS Resource and Patient Management System, and tribal health system data from the Resource and Patient Management System.
Oliveros, A., & Kaufman, J. (2011). Addressing substance abuse treatment needs of parents involved with the child welfare system. Child Welfare, 90(1), 25-41.
The goal of this paper is to synthesize available data to help guide policy and programmatic initiatives for families with substance abuse problems who are involved with the child welfare system, and identify gaps in the research base preventing further refinement of practices in this area. To date, Family Treatment Drug Court and newly developed home-based substance abuse treatment interventions appear the most effective at improving substance abuse treatment initiation and completion in child welfare populations. Research is needed to compare the efficacy of these two approaches, and examine cost and child well-being indicators in addition to substance abuse treatment and child welfare outcomes.
Osofsky, J.D. (Ed.) (2011). Clinical Work with Traumatized Children. Cohen, J.B., Dakof, G.A., & Duarte, E. (Ch.13) Dependency Drug Court: An Intensive Intervention for Traumatized Mothers and Young Children.The Guilford Press: New York, NY.
Although research on DDC is limited, a small number of studies indicate that drug court has promise. Most DDCs share key elements, including a non-adversarial relationship among the participating partners, comprehensive assessment of service needs, frequent court hearings and drug testing, intensive judicial supervision, enrollment in substance abuse treatment programs designed to improve parenting practices and other necessary services, and the administration of judicial rewards and sanctions. In order to graduate from DDCs, participants must have successfully completed substance abuse treatment, remain compliant with mental health services, have a specified period of continuous abstinence, show evidence of a safe and stable living situation, spend a substantial period of time adequately performing the parental role, and have a life plan initiated and in place (e.g. employment, education, vocational training). DDCs frequently include drug court counselors, who refer clients to substance abuse treatment and other court-ordered services, develop a recovery service plan, and monitor and report clients’ ongoing progress to the court. Although there are numerous components to DDCs, the contributions of the drug court judge and counselors to the effectiveness of drug court are undeniable.
OJJDP. (1998). Juvenile and family drug courts: An overview. Rockville, MD: US Dept of Justice, Office of Justice Programs.
For the purpose of this report, a juvenile drug court is defined as "a drug court that focuses on juvenile delinquency matters and status offenses that involve substance- abusing juveniles." A family drug court is defined as "a drug court that deals with cases involving parental rights, in which an adult is the party litigant, which come before the court through either the criminal or civil process, and which arise out of the substance abuse of a parent." Juvenile and family drug courts provide much earlier and more comprehensive intake assessment for both juveniles and adults and have a much greater focus on the functioning of the family as well as the juvenile and parent than traditional courts. There is a closer integration of the information obtained during the intake and assessment process with subsequent case decisions. There is also greater coordination among the court, the treatment community, the school system, and other community agencies that respond to the needs of juveniles, families, and the court. Because juvenile and family drug courts are relatively new, there has not been a sufficient period of operation to document significant results over the long term. Juvenile and family drug court judges are reporting, however, that their initial experience confirms remarkable sustained turnaround by juveniles and adults in the program who were otherwise at high risk for continued, escalating criminal involvement and illegal substance use. Such indicators as recidivism, drug usage, educational achievement, and family preservation indicate that juvenile and family drug courts hold significant potential. An enclosure provides summary data on juvenile and family drug court activity.
Rittner, B., & Dozier, C.D. (2000). Effects of court-ordered substance abuse treatment in child protection cases. Social Work, 45(2), 131-140.
Courts often play active roles in the lives of families supervised by child protective services (CPS). Judges adjudicate dependency, mandate services, determine placements of children, and order continued supervision or termination of parental rights or services. This study examined the effects of court orders in preventing recurrence of substance abuse in the cases of 447 children in kinship care while under CPS supervision. In addition, the effects of court orders on duration of service and on numbers of placements were studied. Results suggested that court interventions had mixed outcomes. Levels of compliance with mandated substance abuse and mental health treatment did not appear to influence rates of re-abuse or duration of service. Court orders appeared to affect both the number of caretakers and placements the children experienced. Children adjudicated dependent were more likely to have multiple caretakers than those under voluntary supervision. This study suggests that further research is needed to determine how compliance with court-ordered treatment should be used by workers in making decisions about continued supervision. In addition, the authors highlight the importance of adequate substance use and abuse screening in good case planning.
Sanford, J.S. & Arrigo, B.A. (2004). Lifting the Cover on Drug Courts: Evaluation Findings and Policy Concerns. International Journal of Offender Therapy and Comparative Criminol.2005; 49: 239-259. doi: 10.1177/0306624X04273200
Drug treatment courts emerged in 1989 as a court-based solution to an enormous increase of drug-related arrests. Since their inception, drug treatment courts have been subject to empirical and process evaluations to provide quantitative and qualitative data regarding their effectiveness. This article reviews the extant literature on the effectiveness of drug treatment courts and discusses findings regarding various components of the criminal justice system. It is argued that based on empirical evaluation findings, drug treatment courts have achieved success in lowering rates of recidivism among drug offenders, despite problematic methodological and analytical concerns. This article also presents key components and agents of drug treatment courts and discusses their impact and relevance to policy creation and adaptation. It is suggested that when combined with empirical evaluations, process evaluations provide great insight into the drug-treatment- court dynamic. This article concludes with a discussion of the implications of drug treatment courts for justice policy.
Somervell, A.M., Saylor, C., & Mao, C.L. (2005). Public health nurse interventions for women in a dependency drug court. Public Health Nursing, 22(1), 59-64.
There are an increasing number of children placed in foster care due to abuse and neglect. Parents of these children often have difficult drug abuse problems leading to the removal of their children. The cost of caring for these children is staggering, reaching an estimated $24 billion. One program in Northern California that has been created to assist parents is dependency drug court. This research utilized qualitative and quantitative data to identify the perceived needs of women who have graduated from this dependency drug court (n = 50) and what they think the public health nurse (PHN) could do to intervene in the difficult process of going through dependency drug court and reunifying with their children. In addition, select interviews were conducted with former drug court recipients who were functioning as "mentor moms" (n = 4). Themes relating to successful strategies emerged from the interviews. They included respect, validation, empowerment, understanding, and support. Common barriers such as overwhelming feelings of anger, denial, and hopelessness contributed to stress during recovery. Among strategies recommended by the mentor moms was a suggestion for PHNs to bridge the information gap through regular reports on the development and health of their children during the time they reside in foster care.
Sparks, S., Risch, R., & Gardner, M.E. (2011).¡CelebrandoFamilias! An innovative approach forSpanish speaking families at high risk for substance abuse disorders.Prevention Partners.
¡Celebrating Families! (CF!)is one of the few evidence-based practices listed on SAMHSA’s National Registry of Evidence Based Practices focusing on families affected by substance abuse disorders. The program has been successfully administered in English with English evaluation instruments indicating significant impact in four of the five family outcomes (cohesion, communication, family strengths and resilience and organization) measured and one small positive reduction (family conflict). Likewise, four of the five parenting outcomes (parent involvement, supervision, efficacy, and positive parenting style) improved with medium effect size (d = .50 to .60), along with a small positive improvement in parenting skills (LutraGroup, 2007). To evaluate the program in Spanish-speaking populations, the curriculum was translated into Spanish, culturally adapted and piloted at three different sites: Latino Community Development Center (LCDA) Oklahoma City, OK; EMQ-Families First (Dorsa Elementary School) San Jose, CA; and Mexican American Community Services Agency (MACSA) Collaborative in Gilroy CA. Retro-before/after evaluation instruments were completed by 41 mono- lingual (Spanish) parents and 23 bi-lingual youth participants. Responses to open-end questions by the parents about the impact of the program were highly positive. Group leaders were all bi-lingual Spanish from the communities served. They completed evaluation instruments for three age groups of youth at the completion of the 16 weeks program. In addition to the quantitative analysis, the Dorsa school principal was interviewed to obtain an informal observation. Findings: Results were consistent with the findings of the English version, although instruments varied from the English instruments. ¡CelebrandoFamilias! evaluation instruments were under development at the time of the pilot. Therefore some questions were consistent and others differed in wording between the three sites. Adults reported significant satisfaction with the program. Results were consistent with the LutraGroup (2007) findings for English speakers with parents also indicating significant impact on family organization, cohesion, communication, conflict solving, strengths and resilience; positive parenting, parent involvement, improvement in parenting skills, and alcohol and drug use reduction. Group leaders for youth observed very significant positive changes with 96-99% confidence levels. Youth were highly satisfied with the program but not as strongly positive as were adults and youth group leaders. Cognitive scores for the factual material were lower for youth than for adults. Additionally, an unexpected finding was the program’s effectiveness as a primary prevention program at Dorsa Elementary School, one of the pilot sites. At this site five families were referred from Dependency Drug Courts. The additional 16 families voluntarily participated after learning of the program from the Dorsa school principal. These families were from a high risk community but without identified substance abuse problems.
Spartaro, R.M. (2011). Nipping it in the bud®: Adopting a family drug court approach to fighting the cycle of alcohol addiction for children when parents are convicted of DUI. Family Court Review, 49(1), 190-206. DOI: 10.1111/j.1744-1617.2010.01361.x
Many states have implemented Drug Courts in recent years by combining drug and alcohol treatment with ongoing judicial supervision. Through the use of incentives such as reduced and dismissed charges and fines combined with supervised treatment, Drug Courts have been shown to be very effective in helping to break the cycle of addiction, crime, and repeat incarceration for those involved. However, these courts do little to address situations in which the addict is the custodial parent of a minor child, who is exponentially more at-risk for future alcohol addiction simply by being the child of an alcoholic, due to both environmental and biological factors. Thus, while the parent's addiction is theoretically being addressed by the courts, little is being done, absent a showing of abuse or neglect, by the judicial system to combat the seeds of addiction that have already been planted in these children. Therefore, this Note advocates for states to include an alcohol education and counseling program aimed at children of alcohol-related offenders based on the Drug Court Model. Participation in this program would then act as a mitigating factor for the addicted offender when receiving their final sentence. This proposed program would then serve as a model for other states to adopt in the near future.
Wheeler, M. & Fox, C.L. (2006). Drug court practitioner fact sheet: Family dependency treatment court: Applying the drug court model in child maltreatment cases. National Drug Court Institute. Alexandria, VA
Evaluation/Outcome Studies
Boles, S. M., N. K. Young, Moore, T., & DiPirro-beard, S (2007). The Sacramento dependency drug court: Development and outcomes. Child Maltreatment, 12, 161-171.
Dependency Drug Courts (DDCs) are a growing method of addressing the functional status and reunification success of families involved in child welfare and affected by substance use disorders. Despite widespread interest in DDCs, few evaluations have appeared in the literature to help inform the discussion about their effectiveness. This article provides a description of various types of DDCs and reports 24-month reunification rates from the Sacramento DDC. Results indicated that DDC participants had higher rates of treatment participation than did comparison participants. In addition, at 24 months, 42% of the DDC children had reunified versus 27.2% of the comparison children. There were no differences in treatment completion or child reunification rates by parent's primary drug problem. Rates of recidivism were extremely low for both the DDC and comparison groups and did not differ significantly. The results of the present study are encouraging and suggest that rigorous, controlled studies are merited to further evaluate the effectiveness of DDCs.
Bruns, E.J., Pullmann, M., Wiggins, E., & Watterson, K. (2011).King County Family Treatment Court Outcome Evaluation: Final Report. Division of Public Behavioral Health and Justice Policy: Seattle, WA.
There is growing research comparing outcomes for parents in regular dependency courts parents in FTCs. Existing research consistently finds a positive impact of FTCs. A study of four FTCs in several sites across the United States found that FTC participants enrolled in treatment more quickly, received treatment services for a longer mean duration, and were more likely to complete treatment successfully than parents in regular dependency courts. The study also found that FTC participants had their children placed in permanent living situations more quickly and were more likely to reach reunification with their children. Similarly, other research on FTCs has found that participants have a higher number of treatment entries, enroll in treatment earlier, spend more time in treatment, and reach reunification faster than participants in regular dependency court. Boles, Young, Moore, and DiPiroo (2007) found that families receiving FTC services had substantially higher reunification rates than families in regular dependency court. At 24 months after entry, 42% of the FTC children had reunified versus 28% of children whose parents had received standard services, and there were no differences between the groups in subsequent maltreatment reports. This suggests FTCs have a positive impact on reunification without posing additional risks of harm or neglect to children. However, none of these studies have featured random assignment into court types. These outcomes are encouraging, and they fit with the theoretical model of change, which suggests that more timely and intensive supports, coupled with consistent oversight and appropriate sanctions, provide parents with a greater likelihood of success – and a greater chance of being reunified with their children – than regular dependency court procedures. However, few studies have examined the inner workings of FTCs and established direct connections between elements of FTCs and specific outcomes. One area that has been studied is the association between timely access to substance use treatment, successful treatment outcomes, and successful child welfare outcomes. In a study of over 1,900 substance-abusing women who had at least one child placed in out-of home care during a six year period, researchers found that women who entered treatment faster remained in treatment longer and were more likely to successfully complete treatment, and their children spent less time out-of-home and were more likely to be reunified. Timely access to treatment may result in successful case outcomes by placing parents on a positive trajectory for behavior change.
Burrus, S.W., Mackin, J.R., &Finigan, M.W. (2011). Show me the money: Child welfare cost savings of a Family Drug Court. Juvenile and Family Court Journal, 62(3), 1-14.
Family drug courts are programs that serve the complex needs of families involved with the child welfare system due to parental substance abuse. This article summarizes the results of outcomes and selected costs of a system-wide reform located in Baltimore, Maryland. Results from this study found that parents served by the program entered treatment faster, stayed in treatment longer, and completed treatment more often than non-served parents. Children in program families spent less time in foster care and were more likely to be reunified with their biological parents. These outcomes resulted in cost savings, including reduced foster care expenditures.The relationship between parental substance abuse and child welfare involvement is well evidenced in the literature. Between 25% and 80% of child welfare cases involve alcohol and other drugs indicated on the child welfare. In the best interests of the child, child welfare and the substance abuse treatment community must work together to address the challenging needs of parents involved with child welfare who have substance abuse issues. Parents involved with child welfare due to substance use are least likely to be reunified with their children, and these same children are likely to stay in substitute foster care longer. Effectively serving these families is challenging, thereby demonstrating the importance of creative interventions focused on their unique needs. Finally, according to a new U.S. Department of Health and Human Services report, spending on foster care services is steadily increasing nationally each year, a circumstance that underscores the policy implications for addressing the needs of these families.
Carey, S.M., Finnigan, M., Crumpton, D., & Waller, M. (2006). California drug courts,: outcomes costs, and promising practices: A overview of phase II in a statewide study. Journal of Psychoactive Drugs, SARC Supplement 3, 345-356.
The rapid expansion of drug courts in California and the state’s uncertain fiscal climate highlighted the need for definitive cost information on drug court programs. This study focused on creating a research design that can be utilized for statewide and national cost- assessment of drug courts by conducting in-depth case studies of the costs and benefits in nine adult drug courts in California. A Transactional Institutional Costs Analysis (TICA) approach was used, allowing researchers to calculate costs based on every individual’s transactions within the drug court or the traditional criminal justice system. This methodology also allows the calculation of costs and benefits by agency (e.g., Public Defender’s office, court, District Attorney). Results in the nine sites showed that the majority of agencies save money in processing an offender though drug court. Overall,for these nine study sites, participation in drug court saved the state over $9 million in criminal justice and treatment costs due to lower recidivism in drug court participants. Based on the lessons learned in Phases I and II, Phase III of this study focuses on the creation of a web-based drug court cost self-evaluation tool (DC CSET) that drug courts can use to determine their own costs and benefits.
Carey, S.M., Sanders, M.B., Waller, M.S., Burrus, S.W.M, & Aborn, J.A. (2010). Marion County Fostering Attachment Treatment Court Process Outcomes and Cost Evaluation, Final report. Submitted to Oregon Criminal Justice Commission.
This evaluation was funded under the Edward Byrne Memorial State and Local Law Enforcement Assistance Grant Program: Byrne Methamphetamine Reduction Grant Project 07-001. This summary contains process, outcome and cost evaluation results for the Marion County Fostering Attachment Family Treatment Court (FATC).
Carey, S.M., Sanders, M.B., Waller, M.S., Burrus, S.W.M, & Aborn, J.A. (2010). Jackson County Fostering Attachment Treatment Court Process Outcomes and Cost Evaluation, Final report. Submitted to Oregon Criminal Justice Commission.
This evaluation was funded under the Edward Byrne Memorial State and Local Law Enforcement Assistance Grant Program: Byrne Methamphetamine Reduction Grant Project 07-001. This summary contains process, outcome and cost evaluation results for the Jackson County Community Family Court (CFC).
Green, B.L., Furrer, C., Worcel, S., Burrus, S., & Finigan, M.W. (2007). How effective are family treatment drug courts? Outcomes from a four-site national study. Child Maltreatment, 12(1), 43-59.
Family treatment drug courts (FTDCs) are a rapidly expanding program model designed to improve treatment and child welfare outcomes for families involved in child welfare who have substance abuse problems. The present study examines the effectiveness of the FTDC in improving treatment and child welfare outcomes for parents. This study compares outcomes for 250 FTDC participants to those of similar parents who did not receive FTDC services in four sites. Results show that FTDC parents, compared to comparison parents, entered substance abuse treatment more quickly, stayed in treatment longer, and completed more treatment episodes. Furthermore, children of FTDC parents entered permanent placements more quickly and were more likely to be reunified, with their parents, compared to children of non-FTDC participants. Finally, the FTDC program appears to have a "value added" in facilitating positive child welfare outcomes above and beyond the influence of positive treatment experiences. The authors note that one important aspect of the FTDC context that has been seen as important to its success is the increased information sharing between treatment, child welfare, the courts, and the regular contact between judges and participants. The study also suggests that FTDCs are supporting parents who may struggle with treatment.
Green, B.L., Furrer, C.J., Worcel, S.D., Burrus, S.W., & Finigan, M.W. (2009). Building the evidence base for family drug treatment courts: Results from recent outcomes studies. Drug Court Review, 6 (2), 53-82.
Family Drug Treatment Courts (FDTCs) are an increasingly prevalent program designed to serve the multiple and complex needs of families involved in the child welfare system who have substance abuse problems. It is estimated that over 301 FDTCs are currently operational in the United States. Few rigorous studies of FDTCs have examined the effectiveness of these programs. This paper reviews current FDTC research and summarizes the results from four outcome studies of FDTCs. Results suggest that FDTCs can be effective programs to improve treatment outcomes, increase the likelihood of family reunification, and reduce the time children spend in foster care. However, further research is needed to explore how variations in program models, target populations, and the quality of treatment services influence effectiveness.
Gyudish, J., Wolfe, E., Tajina, B., & Woods, W.J. (2001). Drug court effectiveness: A review of California evaluation reports. Journal of Psychoactive Drugs, 33, 369-378.
Over the past two decades, drug courts have emerged as a viable alternative for addressing drug cases within the criminal justice system. In California, the Drug Court Partnership Program (DCPP) was created in 1998 and has supported and funded the development of drug courts throughout the State. This article reports on a review of California drug court evaluations through January 2000 conducted as part of an evaluation of the California DCPP. A total of 23 evaluations were collected. Seventeen were reviewed in detail, and six were excluded because they were internal reports rather than evaluations. A standardized review process was initiated which led to a scored rating of the evaluation reports. Results of this review support previous findings that drug court participants may experience reduced re-arrest rates by 11% to 14%compared to nonparticipants. The largest reduction in re-arrest rates appears among graduates. The graduation rates were between 19% and 54%. Costs and savings associated with drug courts were discussed but no conclusions were possible based on the findings from these evaluations. The evaluation of the effectiveness of drug courts presents unique challenges. This review concludes with a discussion of evaluation methods (e.g. standardizing rate calculations, term definitions) that would strengthen drug court research.
Harwin, J., Ryan, M., Tunnard, J., Alrough, B., Matias, C., Momenian-Schneider, S., &Pokhrel, S. (2011).The family drug & alcohol court (FDAC) evaluation project. Brunel University, FDAC Research Team: Final Report.
This report presents the findings from the evaluation of the first pilot Family Drug and Alcohol Court (FDAC) in Britain. FDAC is a new approach to care proceedings, in cases where parental substance misuse is a key element in the local authority decision to bring proceedings. It is being piloted at the Inner London Family Proceedings Court in Wells Street. Initially the pilot was to run for three years, to the end of December 2010, but is now to continue until March 2012. The work is co-funded by the Department for Education (formerly the Department for Children, Schools and Families), the Ministry of Justice, the Home Office, the Department of Health and the three pilot authorities (Camden, Islington and Westminster). The evaluation was conducted by a research team at Brunel University, with funding from the Nuffield Foundation and the Home Office. FDAC is a specialist court for a problem that is anything but special. Its potential to help break the inter-generational cycle of harm associated with parental substance misuse goes straight to the heart of public policy and professional practice. Parental substance misuse is a formidable social problem and a key factor in around a third of long-term cases in children’s services in some areas. It is a major risk factor for child maltreatment, family separation and offending in adults, and for poor educational performance and substance misuse by children and young people. The parents’ many difficulties create serious problems for their children and place major demands on health, welfare and criminal justice services. For these reasons, parental substance misuse is a cross-cutting government agenda. FDAC is distinctive because it is a court-based family intervention which aims to improve children’s outcomes by addressing the entrenched difficulties of their parents. It has been adapted to English law and practice from a model of family treatment drug courts that is used widely in the USA and is showing promising results with a higher number of cases where parents and children were able to remain together safely, and with swifter alternative placement decisions for children if parents were unable to address their substance misuse successfully. The catalysts for the FDAC pilot were the encouraging evidence from the USA and concerns about the response to parental substance misuse through ordinary care proceedings in England: poor coordination of adult and children’s services; late interventions to protect children; delays in reaching decisions in court; and soaring costs of proceedings, linked to the cost of expert evidence.
McCoy, C. (2010). Do drug courts work? For what, compared to what? Qualitative results from a natural experiment. Victims and Offenders, 5, 64-75. doi: 10.1080/15564880903423102.
This is an outcome study of addicts who were sentenced to treatment in a drug court which began operations in 1997. Ten years later, we located and interviewed 25 people from three groups: (1) drug court clients, (2) addicts rejected from drug court and imprisoned, and (3) addicts accepted into drug court but who instead entered traditional drug treatment programs. We explored measures of success such as ability to stay off drugs, hold jobs, maintain family relationships, and the more typically-used outcome variable: recidivism. Drug court clients had better life outcomes than offenders who went to prison, but those who participated in traditional in-community drug treatment were equally successful. Lack of recidivism as indicated in criminal records may be an inaccurate measure of success, since the study found that some subjects' records were clean because they had died. The number of study subjects is too small to draw broad conclusions about program effectiveness, but the results raise concerns about the methodology of many drug court evaluations.
Pach, N.M. (2008). An overview of operational family dependency treatment court outcomes. Drug Court Review, 67-122.
The intent of this article is to lay the groundwork for a national conversation about Family Dependency Treatment Courts (FDTCs). While FDTCs are in many ways similar to drug courts, they have their own set of complications that render NADCP’s 10 key components necessary, yet insufficient, to guide the establishment, maintenance, and improvement of FDTCs. Questions about best practices surround such issues as child welfare, the Adoption and Safe Families Act (1997) timelines, the civil court arena, and the scope of the intervention. When the best interests of the child are paramount, sanctions and incentives for an alcohol and other drug (AOD)-involved parent must be carefully handled. Federal timelines must be fully considered by FDTCs in their planning. Sanctions in particular are complicated by the fact that FDTCs occur in a civil arena rather than the criminal one like traditional drug courts. Finally, a court must decide whether the FDTC intervention will consider a full range of psychosocial and legal problems facing a particular family, or if it will concentrate solely on AOD involvement. This article should serve as a focal point through which those professionals involved in FDTCs can create their own components necessary for FDTCs.
Worcel, S., Furrer, C., Green, B.L., & Rhodes, B. (2006). Family treatment drug court evaluation final phase I study report. Portland, OR: NPC Research.
This report presents the final analysis of Phase I of the Family Treatment Drug Court (FTDC) Evaluation. The FTDC Evaluation, funded by the U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment, is a 4-year study conducted by NPC Research aimed at investigating the short- and long-term child welfare and treatment outcomes for families involved with these innovative programs. There are four study sites participating in this evaluation: San Diego County, CA; Santa Clara County, CA; Suffolk County, NY; and Washoe County, NV. The Phase I design collected archival administrative data on past participants in the FTDCs and similar comparison group cases, and included information about placement changes, types of placements, treatment services and outcomes, case lengths and resolutions, and demographic and background information about the families involved with the cases. Results indicated that rapid entry into drug court and treatment services appear to be related to a number of positive outcomes, including more treatment completion, shorter times to permanent placement, and shorter case closure. In addition, parents who entered treatment faster, stayed in treatment longer, and completed treatment were more likely to graduate from drug court and were more likely to have faster time to permanent placement.
Worcel, S. D., Furrer, C. J., Green, B. L., Burrus, S. W. M., & Finigan, M. W. (2008). Effects of family treatment drug courts on substance abuse and child welfare outcomes. Child Abuse Review, 17(6), 427-443.
This paper presents results from the first large-scale outcome study of American Family Treatment Drug Courts (FTDCs)—specialized courts designed to work with substance- abusing parents involved with the child welfare system. The paper examines whether court, child welfare and treatment outcomes differed for 301 families served through three FTDCs as compared to a matched sample of 1,220 families with substance abuse issues who received traditional child welfare services. Propensity score weights were used to account for measured differences between the FTDC and comparison groups. Child welfare outcomes were analyzed using analytical techniques that controlled for these inherently nested data (i.e. children within a family). Overall, the study found that FTDC mothers had more positive treatment outcomes than similar mothers who were not served by the FTDC. FTDC mothers were more likely to enter substance abuse treatment services than were non-FTDC mothers, entered treatment more quickly after their initial court petition than did non-FTDC mothers, spent twice as much time in treatment than did non-FTDC mothers and were twice as likely to complete at least one treatment episode than non-FTDC mothers. In addition, data from the study indicate that FTDCs influence a key child welfare variable of interest: FTDC children were significantly more likely to be reunified with their mothers than were un-served children.
Judicial Perspectives: Sanctions and Rewards
Bolt, R. & Singer, A. (2006). Juristocracy in the trenches: Problem-solving judges and therapeutic jurisprudence in drug treatment courts and unified family courts. Maryland Law Review, 65, 82-99.
This article explores the role of judges on two types of "problem-solving courts": drug treatment courts and unified family courts. It compares the behavior these "problem- solving" judges to more traditional models of judicial behavior and to activist judging at the appellate level. The authors conclude that the judges who serve on these problem- solving courts have largely repudiated the classical judicial virtues of restraint, disinterest and modesty in favor of a more activist and therapeutic stance. However, the causes and consequences of this role-shift are complex. In particular, the authors suggest that the proliferation of problem solving courts and judges is not primarily a "trickle-down" effect of activist judging at the appellate level; rather, these developments are a response to powerful political and institutional forces outside the judicial system. Legal scholars who seek to understand "juristocracy in the trenches" should therefore broaden their analytic focus to include the ways in which these institutional forces shape the behavior of state trial court judges.
California Supreme Court bars jailing parents for treatment non-compliance. (2009). Alcoholism & Drug Abuse Weekly, 21(14), 3-3.
The article discusses a court case wherein a parent cannot be put to prison for not complying with substance abuse treatments. A ruling from the California Supreme Court allows parents to regain custody of their children without attending ordered treatments. According to Judge Carol Corrigan, parents cannot be forced by the court in participating in such treatments. Prior to the ruling was a woman's release after the termination of her parental rights when her child was positive for methamphetamine.
Edwards, L. (2010). Sanctions in family drug treatment courts. Juvenile and Family Drug Treatment Court Journal, 61, 55-62.
We all know that sanctions and rewards are essential parts of the success of Family Drug Treatment Courts (FDTC), but no one is clear about what these sanctions and rewards should be. Each local court has its own set of sanctions and rewards, many borrowed from criminal drug courts, some created by available resources within the community. Now the California Supreme Court has made the decision about sanctions more complex with its decision in In re Nolan W.1 holding that imprisonment cannot be used as a sanction in the FDTC. What are permissible sanctions in an FDTC? After In re Nolan W., are fines or community service permissible? What about a reduction in visitation? What guidance has the California Supreme Court given trial courts in these areas? This article will try to bring some clarity to these questions and also offer a framework for trial courts to consider regarding the most effective use of sanctions in FDTCs. The article concludes that imprisonment is an unnecessary sanction in FDTCs, and that sanctions in these courts should be guided solely by treatment considerations.
Edwards, L.P., & Ray, J.A. (2005). Judicial perspectives on family drug treatment courts. Juvenile and Family Court Journal, 56(3), 1-27.
Family Drug Treatment Courts are a specialized calendar or docket that operates within the juvenile dependency court. These courts provide the setting for a collaborative effort by the court and all the participants in the child protection system to come together in a non-adversarial setting to determine the individual treatment needs of substance-abusing parents whose children are under the jurisdiction of the dependency court. This article is intended to give judges and others a judicial perspective on FDTCs, and to offer some assistance for those who are operating or who are considering creating one.
Linquist, C.H., Krebs, C.P., & Lattimore, P.K. (2006). Sanctions and rewards in drug court programs: Implementation, perceived efficacy, and decision making. Journal of Drug Issues, 36, 119-145.
Utilizing several Florida drug court programs, results indicate that the number of sanctions used by the drug court programs greatly exceeded those used by traditional courts or probation. Key stakeholders identified numerous behaviors (18 distinct behaviors) likely to result in sanctions. The extensiveness of sanctions used was substantially greater than that of the rewards used, with only half as many rewards as sanctions identified to encourage compliance. Lastly, derived from a qualitative analysis, the drug court programs appeared to emphasize tailoring the sanction to the individual participant, rather than applying sanctions in a uniform manner. However, it is recommended that additional research be conducted to address how drug court programs’ sanctioning systems related to program effectiveness. This study addressed several research gaps in the drug court literature regarding implementation, perceived effectiveness, and decisionmaking pertaining to sanctions and rewards. In selecting five Florida judicial circuits, this process evaluation examined the use of rewards and sanctions to reinforce compliance and to compare linkages among the courts, treatment, and probation in drug courts and traditional courts. Tables and references
Meyer, W. (2007). Developing and delivering incentives and sanctions. National Drug Court Institute.
Traditionally, responses by the criminal justice system to offender behavior exact retribution for what the offender has done and/or punish the offender with the hope that the behavior will not be repeated. Research demonstrates this approach has been totally inadequate to stem drug abuse and related crime in the United States. Deterrence theory posits that the decision to commit a criminal act is influenced by the perception that the certainty, severity and celerity (swiftness) of the consequences. Conventional criminal case processing relies heavily on severity of the consequences and ignores the importance of certainty and swiftness. Drug courts utilize scientifically accepted behavioral modification tools of certainty, swiftness and graduated severity coupled with incentives to permanently change offender behavior. This chapter assists the drug court team in developing the necessary responses to shape offender behavior and identifies the skills for delivering effective response
Whiteacre, K.W. (2007). Strange bedfellows: The tension of coerced treatment. Criminal Justice Policy Review, 18, 260-273. doi: 10.1177/0887403407300088
The use of sanctions in drug treatment courts (DTCs) to enforce participant compliance with treatment represents the convergence of two different, sometimes opposing, correctional philosophies, punishment and rehabilitation. Though the literature on DTCs tends to treat this merging of ideologies unproblematically, it could present a possible source of conflict within DTCs and other coercive treatment programs. Exploratory interviews with staff and participants in a juvenile drug court (JDC) (n 37) uncovered two types of tension resulting from the sanctioning system. First, staff members often disagreed with each other over the appropriateness of rewards versus punishments and punishment severity to motivate compliance. Second, staff members experienced personal ambivalence over the efficacy of sanctions as a therapeutic tool, particularly when faced with some juveniles’ continued noncompliance despite the sanctions. Staff neutralized this tension by attributing noncompliance to the juveniles’ lack of motivation, concluding coerced treatment only works for those who are “ready” for treatment. This would appear to pose a paradox for coerced treatment, which is meant to induce compliance specifically among those who are not motivated. Future research should investigate the implications this ideological contradiction among staff has for the therapeutic outcomes of coerced treatment settings.
Ten Science-Based Principles of Changing Behavior Through the Use of Reinforcement and Punishment
William Meyer Sr. Judicial Fellow National Drug Court Institute
1. SANCTIONS SHOULD NOT BE PAINFUL, HUMILIATING OR INJURIOUS.
a. Research on offender perceptions and specific deterrence effects on offenders subject to sanctions report that:
1. Certainty of sanctions does exert a specific deterrent effect on future behavior.
2. Perceived severity, if certainty is present, does not exert a deterrent effect on future behavior. Harrell, A., & Roman, J. (2001). “Reducing Drug Use and Crime Among Offenders: The Impact of Graduated Sanctions.” Journal of Drug Issues, 31 (1), 207-232.
3. Exploratory studies report that drug court participants who perceived a more certain and meaningful connection between their own conduct and the imposition of sanctions and rewards tended to have better outcomes than individuals who did not perceive such a connection. Douglas B. Marlowe, David S. Festinger, Carol Foltz, Patricia A. Lee, Nicholas S. Patapis, “Perceived deterrence and outcomes in drug court”, Behavioral Sciences and the Law, v.23: 181-198 (2005)
b. While research on animals indicate that severity of punishment is directly related to behavior extinguishment, the same is not necessarily true for criminal offenders.
Research reports that controlling for age, socioeconomic status, and time of incarceration the risk that the offender would re-offend was not related to the prior sanctions imposed irrespective of whether the sanction was probation, a fine or prison. The one exception to this finding is when first and second time offenders received prison instead of a fine or probation, they were more likely to re-offend. Brennan, P and Mednick, S., “Learning Theory Approach to Deterrence of Criminal Behavior,” Vol. 103 Journal of Abnormal Psychology, pp. 430-440 (1994).
c. In controlled studies, participants tend to choose heavy future punishment over smaller immediate punishers. As it relates to substance abusers, they tend to discount the future consequences. The immediacy of the effect is the best predictor of whether there will be a change in the status quo. Murphy, J. G., Vuchinich, R. E., & Simpson, C. A. (2001). “Delayed Reward and Cost Discounting.” The Psychological Record, 51, 571-588.
d. Multi-disciplinary research posits that defiant behavior results when sanctions are perceived as unfair punish the individual not the act, imposed on individuals poorly bonded to the community and on individuals who fail to feel shame or contrition for their acts. Sherman, L. W. (1993). “Defiance, Deterrence, and Irrelevance: A Theory of the Criminal Justice Sanction.” Journal of Research in Crime and Delinquency, 30 (4), 445-473.
2. RESPONSES ARE IN THE EYES OF THE BEHAVER.
a. Contrary to expectations, incarceration is not necessarily viewed by the criminal offender as the harshest punishment. In a comparison of alternative sanctions to prison time, 6-24% of inmates surveyed preferred 12 months incarceration compared to sanctions ranging from a halfway house (6.7%), probation (12.4%) or day fines (24%). Those inmates desiring alternative sanctions seemed to have better connections with the community, for example children, job, etc. Wood, P. B., & Grasmick, H. G. (1995). “Inmates Rank the Severity of Ten Alternative Sanctions Compared to Prison.” Oklahoma Department of Corrections: www.doc.state.ok.us/DOCS/OCJRC/OCJRC95/950725j.htm See also Petersilla, J. and Deschanes, E., “What Punishes? Inmates Rank the Security of Prison v. Intermediate Sanctions?” Federal Probation, Vol. 58, No. 1 (March 1994).
b. Research also indicates that punishment or the possibility of punishment as a sanction tends to be a greater motivator of behavior for those addicts who have a lot to loose. For those addicts who have nothing to lose, the threat or actual imposition of punishment causes them to withdraw from treatment or drop out. The use of positive reinforcement has been shown to be particularly effective in motivating abstinence in this population. See Higgins, S. T., & Silverman, K. (1999). Motivating Behavior Change Among Illicit-Drug Abusers. Washington, D.C.: American Psychological Association; particularly Chapter 17, Crowley, T., “Clinical Implications and Future Directions,” pp. 345-351. c. An extensive study focusing on whether criminal sanctions reduce, increase or have no effect on future crimes found the following:
1. Similar sanctions have completely different effects depending upon the social situation and offender type.
2. Treatment can increase or decrease criminality depending on offenders’ personality type.
3. Criminal sanctions decrease criminality in employed offenders but increase criminality in unemployed offenders.
4. Threat of criminal sanctions deters future criminality in people who are older.
5. People obey laws more when they believe laws are enforced fairly. See Sherman, L. W. (1993). “Defiance, Deterrence, and Irrelevance: A Theory of the Criminal Justice Sanction.” Journal of Research in Crime and Delinquency, 30 (4), 445- 473. d. The concept of the perception of fairness and its effect on the behaver may have greater importance than previously believed. Behavioral economic research suggests that people will react to perceived unfairness by engaging in activity that will “punish” the person perceived as being unfair even to the extent of punishing themselves to get back at that person. Andreoni, J., Harbaugh, W., & Vesterlund, L. (2001). “The Carrot or the Stick? Rewards, Punishments and Cooperation.” Unpublished paper, National Science Foundation Grant. e. Just as a sanction may be misperceived, so can a system of rewards. Providing such things as appointment books, pencils or even increasing monetary rewards as a bonus may even jeopardize continued abstinence. Higgins, S. T., & Silverman, K. (1999). Motivating Behavior Change Among Illicit-Drug Abusers. Washington, D.C.: American Psychological Association., pp. 334- 335. f. As drug court professionals we must be particularly cognizant of the participant perception that a response of increased drug treatment imposed upon therapeutic recommendation will be perceived by the participant as a punishment. To the extent we can persuade the participant that treatment is in their best interest, we should do so. See Center for Substance Abuse Treatment, “Combining Substance Abuse Treatment with Intermediate Sanctions for Adults in the Criminal Justice System.” Rockville, Maryland: Center for Substance Abuse Treatment, U.S. Department of Health and Human Services publication SMA 94-3004; 1994 d. Treatment Improvement Protocol (TIP) Series 12.
3. RESPONSES MUST BE OF SUFFICIENT INTENSITY.
a. Animal Research has demonstrated that punishment must be of sufficient intensity to motivate the change in behavior. If the punishment is of not sufficient consequence, the behaver is not motivated to change or becomes habituated to the punishment Azrin, N. and Holz, W. “Punishment” in Honig W. (ed). Operant Behavior: Areas of Recidivism and Application. (Meredith Publishing 1966) pp. 381-447. Particularly p. 426 and 433. Using animal testing, authors answer whether punishment is effective in eliminating undesirable behavior and what has to be present to heighten efficacy.
b. Research also indicates that graduated sanctions work in the drug court context. Using the DC drug court, a positive drug test sanction group was compared with a group not sanctioned for positive urine testing. The graduated sanction group had significantly fewer arrests than the non-sanctioned group. Harrell, A., & Roman, J. (2001). “Reducing Drug Use and Crime Among Offenders: The impact of Graduated Sanctions.” Journal of Drug Issues, 31 (1), 207-232.
c. Research on graduated rewards demonstrates that participants receiving graduated reinforcement achieved greater mean levels of abstinence than participants receiving fixed reinforcement. Roll, J., Higgins, S. and Badger, G. “An Experimental Comparison of Three Different Schedules of Reinforcement of Drug Abstinence Using Cigarette Smoking as an Exemplar.” Journal of Applied Behavioral Analysis, Vol. 29, p. 495-504 No. 4 (Winter 1996).
d. A word of caution to practitioners: Some rewards may actually interfere with a person’s intrinsic motivation. (See unintended consequences below). Deci, E. L., Koestner, R., & Ryan, R. M. (1999). “A Meta-analytic Review of Experiments Examining the Effects of Extrinsic Rewards on Intrinsic Motivation.” Psychological Bulletin, 125 (6), 627-668.
4. RESPONSES SHOULD BE DELIVERED FOR EVERY TARGET BEHAVIOR.
a. Early animal research pointed out that punishment is only effective if it is delivered for every targeted behavior. Azrin, N. and Holz, W. “Punishment” in Honig W. (ed). Operant Behavior: Areas of Recidivism and Application. (Meredith Publishing 1966) pp. 381- 447. Particularly p. 426 and 433.
b. Outcomes in the criminal justice context is in line with animal- based research. In work by Brennan & Mednick, those offenders who received sanctions on a continuous schedule evidenced a significantly lower arrest rate than those offenders who received intermittent sanctions. Brennan, P. and Mednick, S. “Learning Theory Approach to the Deterrence of Criminal Recidivism.” Vol. 103, Journal of Abnormal Psychology, pp. 430-440 (1994).
c. Experts in contingency management suggest that reinforcers be used for every target behavior. Higgins, S. T., & Silverman, K. (1999). Motivating Behavior Change Among Illicit-Drug Abusers. Washington, D.C.: American Psychological Association. (Particularly see Kirby and Crowley pp. 334 and 349). Recent research indicates the mere opportunity to participate in getting an immediate reward can be effective in changing behavior. Participants who had clean urine tests were given an opportunity to draw paper slips from a fishbowl. Prizes indicated on the slips ranged from nothing to a dollar to a TV set. Results showed group drawing for reward was more likely to complete treatment (84% vs. 22%) and significantly more likely to be abstinent. Petry, N. M., Martin, B., Cooney, J. L., & Kranzler, H. R. (2000). “Give Them Prizes and They Will Come: Contingency Management for Treatment of Alcohol Dependence.” Journal of Consulting and Clinical Psychology, 68 (2), 250-257. Petry, N. M. (2001). “Contingent Reinforcement for Compliance with Goal-related Activities in HIV-positive Substance Abusers.” The Behavior Analyst Today, 2 (2), 78-85.
d. Rewards need not be something tangible to be effective in motivating behavior, praise when delivered both immediately and continuously for achieving target behavior is very effective. Deci, E. L., Koestner, R., & Ryan, R. M. (1999). “A Meta-analytic Review of Experiments Examining the Effects of Extrinsic Rewards on Intrinsic Motivation.” Psychological Bulletin, 125 (6), 627-668.
5. RESPONSES SHOULD BE DELIVERED IMMEDIATELY.
a. In laboratory settings, a one hour delay in imposition of punishment has been demonstrated to decrease the sanctions’ ability to change behavior. Delay in imposition of sanctions can allow other behaviors to interfere with the message of the sanction. Marlowe, D. B., & Kirby, K. C. (1999). “Effective Use of Sanctions in Drug Courts: Lessons from Behavioral Research.” National Drug Court Institute Review, II (1), 11-xxix.
b. Similarly, experts in contingency management recommend that the uses of positive and negative reinforcements are more efficacious when imposed immediately. Griffith, J. D., Rowan-Szal, G. A., Roark, R. R., & Simpson, D. D. (2000). “Contingency Management in Outpatient Methadone Treatment: A Meta-analysis.” Drug and Alcohol Dependence, 58, 55-66. Higgins, S. T., & Silverman, K. (1999). Motivating Behavior Change Among Illicit-drug Abusers, Washington, D.C.: American Psychological Association, pp. 334. Burdon, W., et al. “Drug Courts and Contingency Management.” Journal of Drug Issues, 31(i), pp. 73-90 (2001). c. What we have learned about the schedule of reinforcement from behavioral research is now being confirmed by the biomedical brain research. The effects of reinforcement appear to be exerted in the brain areas that are part of the dopamine reward system. From brain research, scientists conclude, “rewards and punishments received soon after an action are more important than rewards and punishments received later.” Dayan, P., & Abbott, L. F. (2001). Theoretical Neuroscience: Computational and Mathematical Modeling of Neural Systems. Cambridge, MA: MIT Press.
6. UNDESIRABLE BEHAVIOR MUST BE RELIABLY DETECTED.
a. Early studies by Crowley and others demonstrated in a contingency management situation, abstinence must be reliably detected. Higgins, S. T., & Silverman, K. (1999). Motivating Behavior Change Among Illicit-Drug Abusers. Washington, D.C.: American Psychological Association. (Particularly see Kirby’s chapter, pp. 330-332 and Crowley’s chapter, p. 339).
b. Failure to reliably detect drug use in effect puts a person on an intermittent schedule of rewards and sanctions which is ineffectual in changing behavior. Marlowe, D. B., & Kirby, K. C. (1999). “Effective Use of Sanctions in Drug Courts: Lessons From Behavioral Research.” National Drug Court Institute Review, II (1), 11-xxix.
c. Random and frequent scheduling of urine testing that is both quantitative and qualitative can make detection relatively foolproof. See Higgins, S. T., & Silverman, K. (1999). Motivating Behavior Change Among Illicit-Drug Abusers. Washington, D.C.: American Psychological Association, pp. 283-308.
d. The credibility of an intermediate sanction program is dependent upon reliable drug use detection. Torres, S. (1998). “A Continuum of Sanctions for Substance-abusing Offenders.” Federal Probation, 62 (2), 36-45.
7. RESPONSES MUST BE PREDICTABLE AND CONTROLLABLE.
a. Early research in contingency management provided patients with clear, usually written agreements or contracts. Higgins, S. T., & Silverman, K. (1999).,Motivating Behavior Change Among Illicit- Drug Abusers. Washington, D.C.: American Psychological Association, p. 348-349.
b. Abstinence based research indicates that perceived certainty of consequence does have a deterrent effect. Obviously, this perception is based not only on what does occur but what the participant expects will occur. See Harrell, A., & Roman, J. (2001). “Reducing Drug Use and Crime Among Offenders: The Impact of Graduated Sanctions.” Journal of Drug Issues, 31 (1), 207-232.
c. Using a contingency management protocol “requires clear articulation of behaviors that further treatment plan goals,” Burdon, W., et al. “Drug Courts and Contingency Management.”, Journal of Drug Issues, 31(i), pp. 73-90 (2001).
d. Failure to specify particular behaviors that are targeted and the consequences for non-compliance can result in a behavior syndrome known as “learned helplessness where a drug court participant can become aggressive, withdrawn and/or despondent.” Marlowe, D. B., & Kirby, K. C. (1999). “Effective Use of Sanctions in Drug Courts: Lessons from Behavioral Research.”, National Drug Court Institute Review, II (1), 11-xxix.
8. RESPONSES MAY HAVE UNINTENTIONAL SIDE EFFECTS.
a. Punishments that are too excessive or used inappropriately may cause unanticipated side effects like learned helplessness. Marlowe, D. B., & Kirby, K. C. (1999). “Effective Use of Sanctions in Drug Courts: Lessons from Behavioral Research.”, National Drug Court Institute Review, II (1), 11-xxix.
b. Applied research in behavior analysis suggests that negative side effects from punishment contingencies include behavioral supervision, fear, anger, escape and avoidance. Higgins, S. T., & Silverman, K. (1999). Motivating Behavior Change Among Illicit- Drug Abusers. Washington, D.C.: American Psychological Association p. 330.
c. Even the application of positive reinforcements can have negative unexpected consequences – the addition of bonus payments to an escalating pay schedule actually reduced weeks of cocaine abstinence. Higgins, S. T., & Silverman, K. (1999). Motivating Behavior Change Among Illicit-Drug Abusers. Washington, D.C.: American Psychological Association p. 335.
d. Frequency of contacts between the judge and drug court participant can actually have a negative impact on successful program completion. However, this does not apply to ASPD participants and those participants with substantial substance abuse problems. Marlowe. D. B., Festinger, D.S., & Lee, P.A. (2003), “The Role of Judicial Status Hearings in Drug Court”, Offender Substance Abuse Report, 3, 33-46. Marlowe. D. B., Festinger, D.S., & Lee, P.A. (2004), “The Judge is a Key Component of Drug Court, Drug Court Review, 4, 1-34. Marlowe, D. B., Festinger, D. S., Lee, P. A., Dugosh, K. L., Beansutti, K. M., (2006) “Matching Judicial Supervision Hearing to Client’s Risk Status in Drug Court”, Crime & Delinquency, 52-1, 52-76,
e. Behavioral research strongly suggests that extrinsic rewards for behavior that is intrinsically motivated can actually reduce the motivation to continue that behavior. Thus, additional economic rewards for a person who intrinsically likes their work can actually reduce desire to work. Motivation by praise is the most effective way of heightening participants intrinsic motivator. Deci, E. L., Koestner, R., & Ryan, R. M. (1999).,“A Meta-analytic Review of Experiments Examining the Effects of Extrinsic Rewards on Intrinsic Motivation.” Psychological Bulletin, 125 (6), 627-668.
9. BEHAVIOR DOES NOT CHANGE BY PUNISHMENT ALONE.
a. Punishment has the drawbacks pointed out under other principles (See 8(a) and (b) above.)
b. Controlled comparisons of reinforcement and punishment report that clients in the reinforcement contingency stayed in treatment while those in the punishment contingency did not. Higgins, S. T., & Silverman, K. (1999). Motivating Behavior Change Among Illicit- Drug Abusers. Washington, D.C.: American Psychological Association, p. 330.
c. Effects of punishment are temporary and the punished behavior returns when the punishment contingency terminates. Higgins, S. T., & Silverman, K. (1999). Motivating Behavior Change Among Illicit-Drug Abusers. Washington, D.C.: American Psychological Association, p. 330.
d. Punishment is most effective when used in combination with other behavior notification techniques such as positive reinforcement. Marlowe, D. B., & Kirby, K. C. (1999). “Effective Use of Sanctions in Drug Courts: Lessons from Behavioral Research.” National Drug Court Institute Review, II (1), 11-xxix. Higgins, S. T., & Petry, N. M. (1999). “Contingency Management: Incentives for Sobriety.” Alcohol Health & Research, 23 (2), 122-127.
f. Recent contingency management research involving stimulant abusers found that the use of prize based incentive reinforcers resulted in improved treatment retention and abstinence. Petry, N., Pierce, J. and Stitzer, M. et. al. “Effect of Prize-Based Incentives on Outcomes in Stimulant Abusers in Outpatient Psychosocial Treatment Programs”, Archives of General Psychiatry, v. 82: 1148- 1155 (Oct. 2005)
10. THE METHOD OF DELIVERY OF THE RESPONSE IS AS IMPORTANT AS THE RESPONSE ITSELF.
a.. If the participant feels that the process is unfair either to him or to others, the participant will be defiant. Andreoni, J., Harbaugh, W., & Vesterlund, L. (2001)., “The Carrot or the Stick?: Rewards, Punishments and Cooperation.”,Unpublished paper, National Science Foundation Grant. Sherman, L. W. (1993). “Defiance, Deterrence, and Irrelevance: A Theory of the Criminal Justice Sanction.” Journal of Research in Crime and Delinquency, 30 (4), 445-473. Thus, the drug court judge must articulate the differences in two apparently similar situations where there is a different judicial response. Otherwise a perception of unfairness will be projected.
b. Research based upon patient physician communication has demonstrated that interpersonal skills and empathic communication can improve patient satisfaction. Hubble, M. A.,Duncan, B. L., & Miller, S. D. (Editors) (1999). The Heart & Soul of Change: What Works In Therapy. Washington, DC: American Psychological Association, p. 274-275.
c. Psychiatrists who are enthusiastic about the effectiveness of a prescribed course of treatment and communicate same to the client obtain a significantly higher success rate (77% to 10%). Hubble, M. A.,Duncan, B. L., & Miller, S. D. (Editors) (1999). The Heart & Soul of Change: What Works In Therapy. Washington, DC: American Psychological Association, p. 277. d. Research has consistently demonstrated that the psychoactive effects of a drug can vary based upon how the physician described the expected effect. Hubble, M. A.,Duncan, B. L., & Miller, S. D. (Editors) (1999). The Heart & Soul of Change: What Works In Therapy. Washington, DC: American Psychological Association, p. 300-309. e. Certain styles of participant – therapist interaction result in more compliant behaviors. For instance, in parent training, confrontational and teaching oriented approaches tended to result in non-compliant responses whereas when support and facilitation were used compliant behaviors resulted. Patterson, G. A., & Forgatch, M. S. (1985). “Therapist Behavior as a Determinant for Client Noncompliance: a Paradox for the Behavior Modifier.” Journal of Consulting and Clinical Psychology, 53, 846-851.
f. Research involving substance abuse (alcohol) using the two styles above confrontative vs. client centered (motivational interviewing - MI) approach resulted in reduced alcohol use in MI group and less resistance to change. Lawendowski, A. L. (1998).,“Motivational Interviewing with Adolescents Presenting for Outpatient Substance Abuse Treatment.”, Unpublished doctoral dissertation, University of New Mexico;. “Dissertation Abstracts International,” 59-03B, 1357;. Miller, W. R., Benefield, R. G., & Tonigan, S. (1993).,“Enhancing Motivation in Problem Drinking: A Controlled Comparison of Two Therapist Styles.” Journal of Consulting and Clinical Psychology, 61, 455-461. g. Motivational interviewing techniques shown to be successful include (1) let client do talking; (2) open-ended questions; (3) no more than two playbacks of what client said per main question; (4) complex reflections (playbacks) should be used at least 50% of the time when summarizing totality of clients statements; and (5) do not move beyond clients level of readiness. Do not warn confront or give unwelcome advice. Miller, B. (1999). Kaiser. “Motivational Interviewing Newsletter for Trainees,” 6 (1), 1-2; Rollnick, S., & Miller, W. R. (1995). “What is Motivational Interviewing?” Behavioral and Cognitive Psychotherapy, 23, 325-334. h. Even brief motivational interventions can be efficacious. Six months after enrolling in a comparison study, 22% oof those who received a brief motivational intervention tested negative for cocaine use and 40% of the opiate abusers tested negative for opiates, compared with 16% and 30% ,respectively who did not receive the intervention. Bernstein J., Bernstein E., et. al., “Brief Motivational Visit at Clinic reduces Cocaine and Heroin Use”, Drug and Alcohol Dependence v.77(1):49-59 (2005)
i. Recent research confirms that motivational interviewing techniques are effective in the drug court context. When a judge uses positive reinforcement with a participant, the number of positive urine tests is lower than when neutral or critical comments are employed. Scott Senjo & Leslie Leip, Testing Therapeutic Jurisprudence Theory: An Empirical Assessment of the Drug Court Process, 3 WESTERN CRIMINOLOGY REVIEW 1-21 (2001) also available at http://wcr.sonoma.edu/v3n1/senjo.html
To: Nancy K. Young From: Nicolette M. Pach Re: RESPONDING TO PARTICIPANT BEHAVIOR Date: July 1, 2009
In Family Drug Courts the goal is safe and stable permanent reunification of children with a parent in recovery within the time frames established by ASFA and matching the child’s developmental tolerance. The FDC field is moving away from the criminal drug court vocabulary of “sanctions” toward a model of “responses” appropriate to the family court dependency cases, designed to assist the parent to ameliorate the issues which brought the family into the child protective system in the first place. The purpose of responding is not to punish the parent, but to enhance the likelihood that the family can be reunited before the ASFA clock requires an alternate permanent plan for the child.
FDC must set and communicate clear concrete expectations for participants so they know what is desirable (acceptable) and undesirable (unacceptable) behavior as they move through the phases of the FDC. FDC must develop clear responses to participant behavior to be used by the team to promote compliance. Responses should be consistent in FDC in so far as is possible, but must be flexible enough to account for the unique individual circumstances of each parent.
With this in mind the FDC should consider the goal of each response to a participant’s compliant or non-compliant behavior. Responses should be designed to achieve a specific clinical (therapeutic) result for the parent in treatment; a protective response if the parent’s behavior puts the child at risk; or a motivational response designed to teach the parent how to engage in desirable behavior and achieve a stable lifestyle.
The FDC must always take into account the impact of a response may have on a child. Parent/child custody or contact should be determined solely on the basis of the child’s safety and best interest, not as a parental sanction or reward. Incentives can be structured to enhance the parent child relationship. Similarly, clinical decisions as to a parent’s treatment may be made in response to behavioral indicators that the current clinical approach is insufficient, but must be determined by treatment professionals as clinically appropriate, not as a punitive sanction
Responses should be strength based focusing on parent’s successes however minor rather than focusing on failings. This encourages parents to use their own resources to overcome difficulties. FDC should avoid using responses that appear punitive merely for the sake of punishment. Incarceration should be avoided in FDC, but where the judge determines it is appropriate, all procedural and due process safeguards must be observed.
Responses should be applied using scientifically based behavioral modification practices to achieve the desired effect. Research indicates that the “Ten Science-Based Principles” as conceptualized by Judge William Meyer (ret.) promote behavioral change by stressing certainty and swiftness in court responses. Responses should be informed by ongoing clinical assessment, motivational strategies, cognitive-behavioral interventions and the development of continuing care strategies. ( See http://www.georgiacourts.org/duidoc/developing%20and%20Delivering%20Incentives% 20and%20Sanctions%204-3-07.pdf )
C:\Documents and Settings\kferguson\Local Settings\Temporary Internet Files\Content.Outlook\SCBWOQPZ\Pach 2008 Responding to Participant Behavior.doc Responding to Participant Behavior in Family Drug Courts
October 21, 2011 Presented by: Linda Carpenter Program Director Alexis Balkey Program Associate Children and Family Futures
This project is supported by Award No. 2009-DC-BX-K069 awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs Introductions
. Linda Carpenter M.Ed. Program Director Children and Family Futures Irvine, California
. Alexis Balkey BA, RAS Program Associate Children and Family Futures Irvine, California
2 Agenda
• Welcome and Opening Remarks
• 3 Essential Elements of Responses to Behavior
• Responses to Behavior in Family Drug Court
• 10 Science-Based Principles
• Rethinking Sanctions and Incentives
• Questions and Discussion
• Next Steps
3 Children and Family Futures
Mission: Improve the lives of children and families, particularly those affected by substance use disorders. CFF Primary Technical Assistance Programs
Children and Family Futures (CFF)
DOJ SAMHSA & ACYF ACYF Office of Juvenile National Center on Regional Justice and Substance Abuse Partnership Delinquency and Child Welfare Program Prevention
Children In-Depth Affected by Technical Methamphetami Assistance ne
http://www.cffutures.org US DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Administration for Children and Families www.samhsa.gov NCSACW In-Depth Technical Assistance Sites (IDTA) Children Affected by Methamphetamine Sites (CAM) Children’s Bureau Regional Partnership Grants (RPG) OJJDP Family Drug Courts (OJJDP)
RPG Sites (53Sites)
Array of Services (11) Child Focused (8) Drug Courts (10) NCSACW IDTA Sites (20 Sites) System-Wide Collaboration (9) 16 States OJJDP Grantees (22 Sites) Treatment Focused (9) FY 2009 (14 ) Tribal (6) NCSACW CAM Sites (12) 3 Tribal Communities 2 Counties FY 20100 (8) Sites 3 Essential Elements of Responses to Behavior
Linda Carpenter
7 3 Essential Elements of Responses to Behavior
1. Addiction is a brain disorder 2. Length of time in treatment is the key. The longer we keep someone in treatment, the greater probability of a successful outcome. 3. The purpose of sanctions and incentives is to keep participants engaged in treatment.
8 ASAM Definition of Addiction
“Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.” Adopted by the ASAM Board of Directors 4/12/2011 ASAM Definition of Addiction
• Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. • Like other chronic diseases, addiction often involves cycles of relapse and remission. • Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.
Adopted by the ASAM Board of Directors 4/12/2011 Addiction affects the brain Proximal vs. Distal Responses
• Timing is everything; delay is the enemy; how can you as a team work on this issue? • Intervening behaviors may mix up the message. • Brain research supports behavioral observation; dopamine reward system responds better to immediacy.
12 Frequency of Responses
• Responses should be delivered for every target behavior. • Undesirable behavior must be reliably detected • Frequency of contact with a Judge needs to be matched with the offender’s needs. High-end need more, low-end need less.
13 Responses to Behavior as an Engagement and Retention Principle • Treatment dropout is one of the major problems encountered by treatment programs; therefore, motivational techniques through appropriate responses to behavior can keep patients engaged and improve outcomes. • Good outcomes are contingent on adequate treatment length. http://www.drugabuse.gov 14 What is Success in FDC? Key Outcomes
Safety Permanency Recovery (CWS) (Court) (AODS) • Reduce re- • Reduce time to • Increase entry into reunification engagement foster care • Reduce time to and retention • Decrease permanency in treatment recurrence of • Reduce days in • Increase abuse/neglect care number of clean UA’s • Increase number of graduates • Decrease Recidivism
15 AFSA Clock
• FDC’s goal is safe and stable permanent reunification with a parent in recovery within the time frames established by ASFA. • Responses aim to enhance the likelihood that the family can be reunited before the ASFA clock requires an alternative permanent plan for the child. 16 Three Clocks: Competing Requirements
Treatment Child’s AFSA Recovery Developmental
17 Responses to Behavior in Family Drug Courts
Alexis Balkey
18 FDC Framework
FDC focus is on treatment
Responses are thus based on treatment
Long-term success is based on achieving compliance through persuasion rather than coercion
19 Phases and Benchmarks
• Set target behaviors for each phase Entering Commencing • Establish clear expectations for every targeted behavior Solidifying - desirable Practicing Gains - unacceptable - concrete - reasonable - agreed upon
Aftercare • Set requirements for advancement based on behavioral change
20 Client Readiness
Low Importance High Importance Low Confidence Low Confidence
Readiness Scale
Low Importance High Importance High Confidence High Confidence
21 Model for Responding to Behavior
Target behaviors for each phase of treatment
Set clear Evaluate Progress expectations for each target behavior
Set requirements for Respond to advancement based behaviors on behavioral change
22 Reinforcement is how substance abuse problem began and is maintained
• Positive reinforcement – it feels good to use. Examples: – Actual effects of the drug (i.e., “the high”) – Social outlet / time with peers – More energy / confidence / self-assurance • Negative reinforcement – it feels bad NOT to use. Examples: – Increased anxiety – Physical withdrawal symptoms – Boredom – Demands made by others (when I’m sober, my husband and I argue constantly; leaving for the bar or passing out is an escape!)
23 10 Science- Based Principles
24 10 Science-Based Principles
1. Sanctions should not be painful, humiliating, or injurious.
2. Responses are in the eye of the behaver.
3. Responses must be sufficient intensity.
4. Responses should be delivered for every target behavior.
5. Responses should be delivered immediately
Meyer, William’s Ten Science-Based Principles of Changing Behavior Through the Use of Reinforcement and Punishment (National Drug Court Institute) 25 10 Science-Based Principles
6. Undesirable behavior must be reliably detected.
7. Responses must be predictable and controllable
8. Responses my have unintentional side effects
9. Behavior does not change by punishment alone
10. The method of delivery of the response is as important as the response itself.
26 Responses to Behavior
Safety Therapeutic Motivational
• A protective • A response • Designed to response if designed to teach the a parent’s achieve a parent how behavior specific to engage puts the clinical in desirable child at risk result for behavior parent in and treatment achieve a stable lifestyle
29 Setting Range of Responses
• FDC team should develop a range of responses for any given behavior • Avoid singular responses, which fail to account for other progress • Aim for “flexible certainty” – the certainty that a response will be forthcoming united with flexibility to address the specific needs of the individual • NDCI Tool
31 Techniques
• Contingency Management • Motivational Interviewing • Teachable Moments • Fishbowl
32 Contingency Management
Clarify Expectations
JSTEPS Clarify Steps
Reinforce positive behaviors
Shapes behaviors Small Steps recognized by Small steps are recognized by the systemthe system
Technique to replace “drug-using rewards” with structure
Behavior contract – binding agreement
33 Motivational Interviewing Four General Principles
Express empathy
Support Self- Efficacy
Roll with Develop resistance discrepancy
34 Change Talk
Desire: I want to change.
Ability: I can change; You know, I’m starting to feel like this just might work out.
Reason: I should change because……I think that using may be causing problems.
Need: I need to change; I’m kind of worried that things might be getting out of hand.
Commitment: I am going to change; I’m definitely going to do something about that. 42 Behaviors that Promote Resistance Talk (and discourage change talk)
• Arguing for change – the counselor directly takes the pro-change side of the argument • Assuming the expert role – lecturing; the counselor has the answers • Criticizing or blaming • Labeling – proposing acceptance of a specific label or diagnosis • Being in a hurry – perceived shortness of time leads counselor to believe that he or she must be more forceful and directive • Claiming preeminence – “I know what’s best for you.”
44 Methods for Evoking Change Talk
• Ask evocative questions – What strengths do you have that would help you beat this, if you decide to stop? • When client offers a reason for change, ask for elaboration. – My mother hounds me about my drinking all the time. – Tell me more about that. What are her concerns? • Query extremes – If you were to keep drinking, what is the worst thing you can imagine happening?
45 Rethinking Sanctions and Incentives
Linda Carpenter
46 Why use rewards to address substance abuse?
• Reinforcement is the main mechanism through which all “natural” behaviors are developed – i.e., “learned.” Examples: – Infancy: comfort and food teach infants to bond to parents – Childhood: praise/approval from adults, time spent with peers make child more likely to go to school – Adulthood: societal respect, status, and money keep adults working
• We are all products of our learning history – B.F. Skinner: “The organism is always right.” – Everyone behaves so as to maximize the reinforcement they receive
47 Why use rewards to address substance abuse? (cont’d)
• 75 years of research, consistent results: Reinforcement is by far the best way to change behavior – Rewarding desired behavior is more effective than punishing undesirable behavior – Teaches what to do, not what NOT to do • Reinforcement is the main technique used in thousands of successful interventions - examples: – Parent training approaches – Developmental disabilities (e.g., autism) – Depression and anxiety treatment • NIDA (2010) review of the literature: “Combining medications (when available) with behavioral therapy
is the best way to ensure success for most patients.”48 Ideas for Positive Reinforcement
• If you meet FDC targets, lots of good things happen • Small things: – Ceremonial acknowledgement of successes – e.g., certificates, an announcement in the court room – Letter or phone call to someone the client cares about, praising the client – A toy that the client can give to his/her child(ren) and take credit for • Big things: – Help finding a job or a better job – Housing assistance – Transportation assistance – Letters of recommendation – Giving the client a role in the court – e.g., engaging the client as a peer leader, to be part of a focus group to discuss ways of improving the court, etc. 49 Ideas for Negative Reinforcement
• If you meet FDC targets, some bad things (may) go away • Small things: – Less frequent or less aversive (e.g., with more privacy) drug testing – Fewer appointments and requirements – Children’s foster parent not treating the parent disrespectfully • Big things: – Using voucher money for something client truly needs – e.g., to pay off a debt – No longer need someone monitoring visits with children – Court personnel advocate for client (e.g., that client can obtain methadone in a more desirable setting)
50 Rethinking Relapse
• Relapse is not the same as treatment failure • Relapse is not an isolated event, but rather a process • Relapse presents a therapeutic opportunity • Re-engagement after relapse • Relapse prevention plan and strategies • Client relapse leads to collaborative intervention to reengage client in treatment and reassess child safety. • Relapse vs. lapse 51 Addiction and other Chronic Conditions Rethinking Sanctions
Use of “sanctions” is not recommended:
• Weekend jail (work detail) • Short term jail sentence • Fines • Tough physical labor • Clean jail • Electronic surveillance or monitoring • GPS monitoring • Electronic bracelet
53 Rethinking Termination
• FDC keep abusers in treatment • FDC should make termination almost impossible to achieve • The longer we keep someone in treatment, the greater probability of a successful outcome. • Grounds: behavior threatens public safety or undermines program integrity
54 Treatment Responses
• Response & treatment alternatives can be discussed in staffing • How are final decisions made? - Treatment by treatment provider - Consequences by the judge
55 Impact on Children and Families
• Accountability is focused on parent • Court must consider impact of a response on children and family as a unit • Visitations should be determined solely on basis of child’s safety and best interest (vs. parent sanction or reward) 56 Role of the FDC Team in Responding to Participant Behavior
• Target behaviors for each phase of treatment • Set clear expectations for each target behavior • Reports to judge; includes progress, highlights successes
57 Critical Questions
• What are the proximal and distal behaviors you are trying to shape? Have you prioritized your target behaviors depending upon the participant’s risk and need over the time period of your program in the phases you have established?
• Do you know the population you serve? Have you assessed for risk and need? Are the responses for addicts of a different magnitude than for abusers considering the proximal and distal target behavior goals for that individual?
58 Critical Questions
• Have you used available local and national resources to expand your range of consequences? Does your list of responses reflect the importance of incentives? • Has team sat down and memorialized the range of responses for compliant and non-compliant behavior? Will NDCI’s Building Consensus tool help? • Are you using the 10 science-based principles in your responses? • Are treatment decisions being made by treatment providers? • What are your grounds for termination?
59 Questions? Technical Assistance
• How do I access technical assistance?
• Visit the Children and Family Futures website for resources and products at www.cffutures.org
• Email us at [email protected] • Call us: 1-866-493-2758
61 Contact Information
Linda Carpenter Program Director, In-Depth Technical Assistance Program National Center on Substance Abuse and Child Welfare (NCSACW) Children and Family Futures (866) 493-2758 [email protected]
Alexis Balkey Program Associate Children and Family Futures (714) 505 – 3525 [email protected] 62 Sanctions Sanctions shall not be imposed for the purpose of punishment. All sanctions imposed shall be gradual in severity and only that necessary to change behavior consistent with treatment.
Sanctions should be designed to change future behavior, not punish past actions!
Sanctions Should be Delivered For Every Infraction ♦No sin should go unpunished ♦“for every action, there is an equal and opposite reaction”
♦ Forgiveness is NOT a drug court concept
♦ All Sanctions and Incentives are determined on a case by case basis
SANCTIONS
Program Interim sanctions and/or interventions will be imposed at treatment to provide immediate response to relapse. Honesty will be rewarded with a lesser/reduced sanction
TYPICAL BEHAVIOR : DRUG TESTING
FAILURE TO TEST CLIENT IS UNABLE TO PRODUCE A URINE SAMPLE OR FAILS TO PRODUCE (20ML) AMOUNT DURING NORMALTESTING TIME. NO SHOW FOR TESTING (ns) NO SHOW FOR TESING WHEN ANNOUNCED ON A SATURDAY, SUNDAY, OR HOLIDAY. UNACCEPTABLE TEST TEMPERATURE POSITIVE UA/ALCOHOL TEST RELAPSES: FIRST SECOND THIRD DILUTED SAMPLE POSSESSION OF ANY TYPE OF ADULTERATION/FLUSHING SUBSTANCES USED FOR MASKING RESTS, INCLUDING BUT NOT LIMITED TO LIQUIDS, POWDERS, PILLS, DYES, DEVICES, ETC. (SEE PAGE 7)
Tier I Tier II Tier III______
FIRST OFFENSE SECOND OFFENSE THIRD OFFENSE Delayed Admit to formal program Detox Residential (min 30 days) Increased Testing Community Services Graduation eligibility delayed Increased Treatment Written/verbal apology to team/group Termination Community Service Increased treatment Increased treatment Increased court appearances Verbal warning from Judge Order from Judge Open apology to team/Group No Phase change for 30 days Verbal warning from Judge
SANCTIONS
Program HONESTY MAY BE REWARDED WITH A LESSER/REDUCED SANCTION
TYPICAL BEHAVIOR : SELF HELP RESPONSIBILITY
FAILURE TO TURN IN SELF HELP MEETING SLIPS BY DATE DUE MEETING SLIPS ARE TURNED IN WITH LESS THEN REQUIRED NUMBER OF MEETINGS. FORGED MEETING SLIPS (SEE PAGE 7) FAILURE TO OBTAIN IN 12 STEP SPONSOR
Tier I Tier II Tier III______
FIRST OFFENSE SECOND OFFENSE THIRD OFFENSE
Warning and or 7 meetings in 7 days plus any 14 meetings in 14 days, plus any sanction Graduation eligibility delayed sanction from sanction pool from sanction pool Termination Increased self help meetings Write Essay Order from Judge
Other writing assignments Outline pages 1-83 of NA basic Text
Journaling Spend day observing court Increased court appearances Community Service Open apology to Group Written/verbal apology to team/Group No Phase change Peer review Essay to Court Verbal warning from Judge
SANCTIONS
Program HONESTY MAY BE REWARDED WITH A LESSER/REDUCED SANCTION
TYPICAL BEHAVIOR : MISCELLANEOUS
INAPPROPRIATE COURTROOM BEHAVIOR NEW DRUG OR ALCOHOL USE PRIOR TO COURT CONTINUOUS RULE VIOLATIONS ABSCONDING FROM PROGRAM (3 DAYS NO CALL NO SHOW) DISHONEST STATEMENT TO JUDGE, TEAM AND/OR TREATMENT QUITTING PROGRAM AFTER PROBATIONARY PRIOD AND BEFORE COMPLETION OBTAINING NEW DRUG CHARGES FAILING TO COMPLY WITH SANCTIONS LEAVING RIVERSIDE WITHOUT PERMISSION ASSOCIATING WITH/LIVING IN A HOME WHERE DRUGS ARE USED/PRESENT
Tier I Tier II Tier III______
FIRST OFFENSE SECOND OFFENSE THIRD OFFENSE
Writing assignments Repeat each phase/specified time Journaling Written/verbal apology to team Graduation eligibility delayed Increased court appearances De-phasing Structured Sober Living Requirement Open apology to team Additional drug testing Termination Increased Treatment Community Service Order from Judge Essays for Court Round Table W/Team
Community Service Verbal warning from Judge
SANCTIONS
Program
TYPICAL BEHAVIOR : Non-compliance
CONTINUALLY FAILS TO MEET REQUIREMENTS IN ONE OR MORE AREAS, OR CONTINUALLY COMMITS RULE VIOLATIONS FAILURE TO PROVIDE CURRENT ADDRESS OR CHANGE OF ANY PERSONAL INFORMATION WITHIN 24 HOURS OF CHANGE. (ADDRESS, PHONE, EMPLOYMENT, SPONSOR, ETC) LEAVING DETOX OR A RESIDENTIAL CARE PROGRAM PRIOR TO COMPLETION WITHOUT THE TEAMS PERMISSION FAILURE TO OBTAIN SOBER LIVING FAILURE TO MEET EMPLOYMENT/SCHOOL MILESTONES OBTAINING NEW DRUG CHARGES USE OF PRESCRIPTION AND/OR OVER THE COUNTER MEDICATION WITHOUT FIRST OBTAINING PERMISSION FROM TREATMENT.
Tier I Tier II Tier III______
FIRST OFFENSE SECOND OFFENSE THIRD OFFENSE
Increased court appearances Graduation eligibility delayed Delay in promotion of phase Placement in structured Sober Living Termination Increased Treatment Community Service Order from Judge Increased Drug Testing Written/verbal apology to team
Verbal warning from Judge Verbal warning from Judge
SANCTIONS
TREATMENT ALL TREATMENT SANCTIONS ARE TO BE IMPOSED BY TREATMENT AND REPORTED TO THE FPC TEAM
TYPICAL BEHAVIOR : TREATMENT
NO CALL – NO SHOW (NC/NS) CLIENT FAILED TO CALL AND SHOW FOR GROUP. CLIENT FAILED TO SHOW PROOF OF AN EMERGENCY. FAILURE TO CALL AND SHOW FOR 3 CONSECUTIVE DAYS CLIENT DID CALL PRIOR TO THE START OF G
Tier I Tier II Tier III______
FIRST OFFENSE SECOND OFFENSE THIRD OFFENSE
Writing assignments Repeat each phase/specified time Journaling Written/verbal apology to team Graduation eligibility delayed Increased court appearances De-phasing Structured Sober Living Requirement Open apology to team Additional drug testing Termination Increased Treatment Community Service Order from Judge Essays for Court Round Table W/Team
Community Service Verbal warning from Judge
SANCTIONS
Program BEHAVIORS THAT WILL RESULT IN IMMEDIATE TERMINATION ARE DISHONEST AND PRECALCULATED ACTIONS.
TYPICAL BEHAVIOR : IMMEDIATE TERMINATION
POSESSION OF ANY TYPE OF ADULTERATION/FLUSHING SUBSTANCES USED FOR MASKING TESTS, INCLUDING BUT NOT LIMITED TO LIQUIDS, POWDERS, PILLS, DYES, DEVICES, ETC. SUBSTITUTING, ALTERING OR TYRING IN ANY WAY TO CHANGE BODY FLUIDS FOR PURPOSES OF TESTING. FORGED MEETINGS DISHONEST STATEMENT TO JUDGE, TEAM AND/OR TREATMENT OBTAINING NEW DRUG CHARGES
Tier I Tier II Tier III______
FIRST OFFENSE SECOND OFFENSE THIRD OFFENSE
Residential Residential Termination from program
Assessment for reentry after 30 days if approved by team.
REWARDS
MOST OF TODAY’S CLINICAL TEXTBOOKS CONCLUDE THAT POSITIVE REINFORCEMENT IS FAR PREFERABLE FOR CHANGING BEHAVIOR [THAN PUNISHMENT].
A good incentive will evoke good feelings in the participant . . . They may feel important, accomplished, liked, respected, or simply recognized.
REWARDS SHOULD BE IMMEDIATE
REWARDS
Program GIFT CERTIFICATES SHOULD BE AWARDED FOR EXTRAORDINARY BEHAVIOR TREATMENT MAY ADD THEIR OWN REWARDS.
EXTRAORDINARY BEHAVIOR :
Maintianing sobriety Share home with others Stayed away from using partner/users Obtaining employment/GED/finishing school Maintain sobriety during stressful life experience (death in Being a mentor or role model family, loss of job, etc) Moving from one phase to another Doing more then is required Completion of Nurturing Families Program Telling the truth/being honest about non-compliant event Graduating Program Helping another client with transportation Helping another client with ______Volunteering time
Tier I Tier II Tier III______
Certificate of Promotion Travel privileges Housing Voucher Praise from the judge Excused from court early Program token Early call list Reduced court appearance Graduation Certificate Gift Certificate (relevant to need) Recognition from the team Clothes/hosehold items Tattoo removal Connect with community for speical needs Legal assistnace with felony/misd
(dental, haircuts, mentoring, employment) Reduce fines